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目的 :比较肾移植后使用三联免疫抑制方案中霉酚酸酯 (MMF)与硫唑嘌呤 (Aza)对受者T细胞亚群功能变化的影响。 方法 :根据使用MMF和Aza情况将 6 1例首次尸肾移植患者分为MMF 1 5g(n =37)、MMF 1 0g(n =10 )和Aza 5 0mg(n =14)三个组。随访患者的有关情况 ,用流式细胞仪检测患者血中的T淋巴细胞亚群 (CD4,CD45RA ,CD8,CD2 8,CD2 5 ,CD95 ,CD95 L)。用SPSS 10统计软件对三组患者的各项数值进行ANOVA总体方差分析 ,并进行SNK两两比较。 结果 :T淋巴细胞亚群分析CD8和CD2 8双阳性 (Tc)的MMF 1 5g组为 14 2± 6 99,MMF1 0g组为 13 0± 6 6 0 ,而Aza组为 19 7± 8 44。使用MMF的二组与Aza组之间统计学差异显著 (P =0 0 40 )。其他所测数据三组之间无显著性差别。 结论 :在以环孢素为基础的三联免疫抑制治疗方案中 ,使用MMF患者的T杀伤细胞 (Tc)水平显著低于使用Aza患者 ,MMF较Aza有着更强的免疫抑制作用。肾移植后使用MMF有利于免疫低反应的形成 ,使患者易于产生移植耐受
OBJECTIVE: To compare the effects of mycophenolate mofetil (MMF) and azathioprine (Aza) on the functional changes of T cell subsets in recipients after triple-immunosuppressive regimen after renal transplantation. METHODS: Sixty-one patients undergoing primary cadaveric kidney transplantation were divided into three groups: MMF 15 g (n = 37), MMF 10 g (n = 10) and Aza 50 mg (n = 14) according to MMF and Aza conditions. T lymphocyte subsets (CD4, CD45RA, CD8, CD28, CD25, CD95, CD95 L) were measured by flow cytometry in patients with follow-up. The data of three groups were analyzed by ANOVA with ANOVA using SPSS 10 statistical software, and SNK was compared with each other. Results: T lymphocyte subsets were 14 2 ± 6 99 in the MMF 1 group with CD8 and CD8 8 double positive (Tc), 13 0 ± 6 6 0 in the MMF1 0g group, and 19 7 ± 8 44 in the Aza group. There was a significant statistical difference between the two groups using MMF and the Aza group (P = 0 0 40). Other data measured between the three groups no significant difference. CONCLUSIONS: In cyclosporin-based triple immunosuppressive regimens, the level of T-killer (Tc) was significantly lower in MMF patients than in patients with Aza, and MMF had a stronger immunosuppressive effect than Aza. The use of MMF after kidney transplantation is conducive to the formation of low immune response, making patients prone to transplant tolerance