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目的探讨雷帕霉素(RPM)在肾移植后发生肿瘤治疗中的作用。方法23例肾移植术后发生肿瘤而无法手术切除的患者,8例在调整免疫抑制方案的同时加用RPM(RPM组),15例调整免疫抑制方案,部分患者接受化疗(非RPM组),对比两组患者的存活情况。结果RPM组患者治疗期间未见急性排斥反应,其中位存活时间为14.5个月,随访至今,仍有7例存活;1例Kaposi肉瘤患者减少RPM用量而发生急性排斥反应,最终因移植肾功能衰竭和肺部感染死亡。非RPM组患者的中位存活时间为3.0个月,随访期内全部死亡。RPM组12个月、20个月的存活率分别为75.0%和37.5%,非RPM组12个月、20个月的存活率分别为7.1%和0,两组间的差异有统计学意义(P<0.05)。结论RPM发挥抗急性排斥反应作用的同时,对肿瘤的发生、发展也有抑制作用。
Objective To investigate the role of rapamycin (RPM) in the treatment of tumors after renal transplantation. METHODS: Twenty-three patients with tumors that were unresectable after renal transplantation were enrolled. Eight patients received RPM (RPM group), 15 patients received immunosuppression regimen, and some received chemotherapy (non-RPM group) Compare the survival of two groups of patients. Results There was no acute rejection during the treatment in the RPM group. The median survival time was 14.5 months. Up to now, 7 patients still survived. One patient with Kaposi’s sarcoma had an acute rejection reaction with reduced RPM and finally had renal allograft failure And lung infection died. The median survival in non-RPM patients was 3.0 months, with all deaths during the follow-up period. The survival rates at 12 months and 20 months in RPM group were 75.0% and 37.5%, respectively. The non-RPM group at 12 and 20 months had survival rates of 7.1% and 0, respectively, with significant differences between the two groups P <0.05). Conclusion RPM play an anti-acute rejection reaction at the same time, the occurrence and development of tumors also have an inhibitory effect.