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目的探讨咪唑立宾(MZR)在肾移植术后的临床应用效果。方法选取2003年8月至2004年4月间肾移植术后采用环孢素A(CsA)或他克莫司(FK506)+MZR+激素三联免疫抑制方案的患者112例,定期检查患者用药后的血常规、肝肾功能、尿酸、血糖、血脂等生化指标;对乙型肝炎病毒、丙型肝炎病毒、艾滋病病毒、巨细胞病毒、EB病毒、腺病毒及带状疱疹病毒进行抗原学或者抗体监测;疑有排斥反应时,行移植肾穿刺病理检查。统计病毒感染发生情况,评价该治疗方案的安全性。结果肾移植术后随访12-20个月,患者的人／肾存活率均为96％;急性排斥发生率为11．6％,经冲击治疗后全部逆转;患者主要不良反应是高尿酸血症,但可以控制而不需要停药;巨细胞病毒感染率为11．6％,未发生巨细胞病毒病;有1例感染腺病毒。结论MZR是一种安全有效的免疫抑制剂,病毒感染的发生率相对较低。由于肾移植术后应用MZR患者主要不良反应是高尿酸血症,因此要注意对患者的尿酸进行控制。
Objective To investigate the clinical effect of mizoribine (MZR) after renal transplantation. Methods One hundred and twelve patients with CsA or FK506 + MZR + triple immunosuppressive regimen after renal transplantation between August 2003 and April 2004 were selected. Blood, liver and kidney function, uric acid, blood glucose, blood lipids and other biochemical indicators of hepatitis B virus, hepatitis C virus, HIV, cytomegalovirus, Epstein-Barr virus, adenovirus and herpes zoster virus antigenic or antibody monitoring ; Suspected rejection, the line of renal biopsy pathology. Statistics of viral infection occurred, evaluate the safety of the treatment plan. Results The follow-up of 12-20 months after renal transplantation showed that the survival rate of human / kidney was 96%, the rate of acute rejection was 11.6%, all of them were reversed after shock treatment. The main adverse reactions were hyperuricemia , But can be controlled without the need for withdrawal; cytomegalovirus infection rate was 11.6%, no cytomegalovirus disease; one case of infected adenovirus. Conclusion MZR is a safe and effective immunosuppressive agent, and the incidence of viral infection is relatively low. As the main adverse drug reaction in MZR patients after renal transplantation is hyperuricemia, attention should be paid to the control of uric acid in patients.