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目的 探讨儿童肾移植免疫抑制治疗特点。方法 回顾性分析 31例儿童肾移植患者(男 18例,女 13例)的临床资料。根据起始免疫抑制方案不同,分为 3组:A组(环孢素A+硫唑嘌呤+泼尼松)7例;B组(环孢素A+霉酚酸酯 +泼尼松)17例;C组 (他克莫司 +霉酚酸酯 +泼尼松)7例。统计 3组免疫抑制药物调整及维持剂量、移植肾功能变化和术后并发症。结果 1年人 /肾存活率为100% /96.8%,3年人 /肾生存率为94.4% /88.9%。三组各观察点肌酐实测值差异无显著性意义 (P<0.05)。他克莫司组药物副作用小且能保持良好的肾功能。泼尼松调整幅度大、维持量小,与其他组差异有显著性意义(P<0.01)。结论 肾移植是儿童终末期肾病的有效治疗措施。遵循儿童个体差异的免疫抑制治疗是移植后预防排斥的重点。他克莫司、霉酚酸酯、泼尼松三联抗排斥治疗是儿童肾移植理想的免疫抑制治疗方案。
Objective To investigate the characteristics of immunosuppressive therapy in children with renal transplantation. Methods The clinical data of 31 children with renal transplantation (18 males and 13 females) were retrospectively analyzed. According to the initial immunosuppressive regimen, there were 3 groups: group A (cyclosporin A + azathioprine + prednisone), group B (cyclosporin A + mycophenolate + prednisone) Group C (tacrolimus + mycophenolate + prednisone) in 7 cases. Statistics 3 groups of immunosuppressive drugs to adjust and maintain the dose, graft function changes and postoperative complications. Results The 1-year survival rate of human / kidney was 100% / 96.8%, and the survival rate of 3 years / kidney was 94.4% /88.9%. There was no significant difference in creatinine among the three groups (P <0.05). Tacrolimus drugs have small side effects and maintain good renal function. Prednisone adjustment range, the maintenance of small, and the other group differences were significant (P <0.01). Conclusion Kidney transplantation is an effective treatment for end-stage renal disease in children. Immunosuppressive therapy following individual differences in children is the focus of prevention of rejection after transplantation. Tacrolimus, mycophenolate mofetil and prednisone triple anti-rejection therapy are ideal immunosuppressive regimens for children with renal transplantation.