中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (53): 9953-9956.doi: 10.3969/j.issn.1673-8225.2011.53.018

• 肾移植 kidney transplantation • 上一篇    下一篇

肾移植后的蛋白尿

沈蓓莉，杨  磊，胡俊杰，王素静，谢红梅，郭晓芳   

  1. 郑州人民医院肾器官移植科，河南省郑州市    450003
  • 收稿日期:2010-11-03 修回日期:2011-01-22 出版日期:2011-12-31 发布日期:2011-12-31
  • 作者简介:沈蓓莉，女，1972年生，河南省郑州市人，汉族，1997年新乡医学院毕业，副主任医师，主要从事肾内科临床研究。 15903711568@139.com

Proteinuria after kidney transplantation

Shen Bei-li, Yang Lei, Hu Jun-jie, Wang Su-jing, Xie Hong-mei, Guo Xiao-fang   

  1. Department of Kidney Transplantation, Zhengzhou People’s Hospital, Zhengzhou   450003, Henan Province, China
  • Received:2010-11-03 Revised:2011-01-22 Online:2011-12-31 Published:2011-12-31
  • About author:Shen Bei-li, Associate chief physician, Department of Kidney Transplantation, Zhengzhou People’s Hospital, Zhengzhou 450003, Henan Province, China 15903711568@139.com

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摘要：

背景：蛋白尿的发生与移植肾的远期存活直接相关，是影响移植肾远期存活、导致肾移植患者死亡的独立危险因素。
目的：观察应用血管紧张素Ⅱ受体阻断剂联合雷公藤多苷治疗肾移植后蛋白尿的效果。
方法：选择肾移植后出现蛋白尿患者45例，分为3组，在常规应用免疫抑制剂基础上，治疗组采用2倍剂量血管紧张素Ⅱ受体阻断剂联合雷公藤多苷1 mg/(kg·d)、雷公藤多苷组采用雷公藤多苷1 mg/(kg·d)，对照组仅维持原有免疫抑制方案治疗。
结果与结论：治疗后12个月治疗组和雷公藤多苷组24 h尿蛋白定量、环孢素A血药浓度、环孢素A用量均显著低于对照组(P < 0.05)，治疗后治疗组尿素氮、肌酐浓度显著低于其他两组(P < 0.05)。提示血管紧张素Ⅱ受体阻断剂联合雷公藤多苷能明显减少肾移植后蛋白尿的出现，且可减少免疫抑制剂的用量，对移植肾起保护作用。

关键词: 肾移植, 蛋白尿, 血管紧张素Ⅱ受体阻断剂, 雷公藤多苷, 治疗

Abstract:

BACKGROUND: Proteinuria directly correlates with long-term survival of transplanted kidney and is an independent risk factor influencing long-term survival of transplanted kidney and leading to death of transplant patients.
OBJECTIVE: To investigate the effects of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides in treatment of proteinuria after kidney transplantation.
METHODS: Forty-five patients presenting with proteinuria after kidney transplantation were divided into three groups: treatment, tripterygium glycosides group and control. In the treatment group, based on conventional application of immunosuppressive agent, 2-fold dose of angiotensin Ⅱ receptor blocker combined with tripterygium glycosides (1 mg/kg per day) were used. In the tripterygium glycosides group, tripterygium glycosides (1 mg/kg per day) was used. In the control group, only immunosuppressive agent was used.
RESULTS AND CONCLUSION: At 12 months after treatment, 24-hour urine protein, ciclosporin A concentration, ciclosporin A dosage were significantly lower in the treatment and tripterygium glycosides groups than in the control group (P < 0.05). After treatment, urea nitrogen and creatinine levels in the treatment group were significantly lower than those in the control and tripterygium glycosides groups (P < 0.05). These findings suggest that angiotensin Ⅱ receptor blocker combined with tripterygium glycosides can obviously decrease urine protein level after kidney and reduce immunosuppressive agent application dose, exhibiting a protective effect on transplanted kidney.

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