论文部分内容阅读
目的 探讨高龄肾移植的临床特点及新型免疫抑制剂对高龄患者的影响。方法 分析 12 5 1例肾移植中 12 6例高龄患者的临床资料 ,将术后使用免疫抑制剂为传统三联疗法 (CsA +Aza +强的松 )的 5 5例作为组Ⅰ ;而术后使用四联疗法 (CsA +MMF+强的松 +抗T细胞单抗 )的 71例作为组Ⅱ ,组Ⅱ中 47例患者术后使用 2周Wu -T3抗排斥治疗 ,另 2 4例应用抗IL -2R抗体预防急性排斥反应。比较两组术后并发症、急性排斥率及 1年人 /肾存活率 ,并与本院同期非高龄患者相同指标比较。结果 高龄患者肾移植术后心脑血管并发症以及机会感染的发生率均明显高于同期非高龄患者 ,组Ⅰ和组Ⅱ的高龄患者术后 1年并发症发生率分别为 74 5 5 %和 38 0 3% ;急性排斥发生率分别为 12 73%和 4 2 3% ;1年人 /肾存活率分别为 81 82 % /78 18%和 97 18% /95 77%。结论 高龄患者肾移植术后比较容易发生心脑血管并发症及感染 ,使用新型免疫抑制剂能有效地降低高龄患者的心脑血管并发症、感染和急性排斥反应的发生率 ,1年人 /肾存活率亦有明显提高
Objective To investigate the clinical features of elderly kidney transplantation and the effect of novel immunosuppressive drugs on elderly patients. Methods The clinical data of 12 6 elderly patients in 125 cases of renal transplantation were analyzed. Fifty-five patients receiving traditional triple therapy (CsA + Aza + prednisone) after immunosuppressive therapy were used as group Ⅰ, while postoperative Forty - seven patients in group Ⅱ were treated with Wu - T 3 anti - rejection for 2 weeks postoperatively, and the other 24 patients were treated with anti - IL - 2R antibodies prevent acute rejection. Comparisons of postoperative complications, acute rejection rate and 1-year survival rate of human / kidney in both groups were compared with the same indexes of non-elderly patients in our hospital at the same period. Results The incidence of cardiovascular complications and opportunistic infections after renal transplantation in elderly patients were significantly higher than those in non-elderly patients at the same period. The incidences of complications at 1 year after operation in elderly patients in group I and group II were 74.5% 38 0 3%. The incidence of acute rejection was 12 73% and 42 23% respectively. The 1-year human / kidney survival rates were 81 82% / 78 18% and 97 18% / 95 77%, respectively. Conclusion The incidence of cardiovascular and cerebrovascular complications and infections is more likely to occur in elderly patients after renal transplantation. The use of new immunosuppressive agents can effectively reduce the incidence of cardiovascular and cerebrovascular complications, infections and acute rejection in elderly patients. One-year human / kidney Survival rate has also significantly improved