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糖皮质激素作为肾移植后免疫抑制药物的核心成分已经超过40年,其作为免疫抑制方案的核心成份,发挥了巨大的作用。但由于其明显的毒副作用,如高血压、高脂血症、糖尿病、骨质疏松症、儿童发育迟缓等,导致患者最终死于感染和心血管疾病,从而增加了患者的死亡率,降低了患者的生活质量,增加了肾移植患者长期治疗的费用。由此人们对激素在肾移植中的长期应用产生了忧虑,国内外众多移植工作者开始探索少用和不用激素的免疫抑制方案。因此,如何尽量减少或早期撤除糖皮质激素以减少其不良反应,发展非糖皮质激素免疫抑制方案(glucocortocoid—freeimmunosuppressiveregimen)已逐渐成为研究的热点。现就这方面的研究进展作一综述。
Glucocorticoids, as the core component of immunosuppressive drugs after kidney transplantation, have been used for more than 40 years and have played a huge role as a core component of immunosuppressive regimens. However, due to its obvious side effects such as hypertension, hyperlipidemia, diabetes, osteoporosis, childhood retardation, etc., the patient finally dies of infection and cardiovascular diseases, thereby increasing the patient’s mortality rate and reducing The patient’s quality of life increases the cost of long-term treatment of kidney transplant patients. As a result, people are concerned about the long-term application of hormones in kidney transplantation. Many transplant workers at home and abroad have begun to explore immunosuppressive programs with and without hormones. Therefore, how to reduce or early remove glucocorticoids to reduce their adverse reactions, the development of non-glucocorticoid immunosuppressive regimen (glucocortocoid-freeimmunosuppressiveregimen) has gradually become a hot spot. The research progress in this area is reviewed.