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免疫抑制药物对多囊肾病治疗作用的探讨
齐隽,朱有华,闵志廉,王炜,王立明
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()
摘要:
目的:探讨免疫抑制药物对成人型多囊肾病(APKD)的治疗作用及其作用机制。方法:回顾总结24例APKD患者肾移植并免疫抑制治疗[均为常规的环孢素A(CsA)、硫唑嘌呤(Aza)、泼尼松(Pred)三联方案]前后情况,对比观察的指标是腰部胀痛、肉眼血尿、高血压、多囊肾大小。结果:移植术后腰部胀痛症状改善最为明显; 术前频发肉眼血尿者为83.3%,术后减为12.5%,相差非常显著(P<0.01);高血压在术后1个月内改善不明显,而在术后1年时改善非常明显(P<0.01);多囊肾B超测定值,术前与术后各期相比, 大小无显著差异,呈现“稳定”状态。结论:APKD患者肾移植术后腰部胀痛、血尿、高血压等症状的改善可归因于免疫抑制药物的治疗作用。推测其作用机制,可能APKD属基因决定基础上的免疫性疾病,或免疫因素在其病程中起重要作用,因此免疫抑制药物可能对APKD具有治疗作用。
关键词:  多囊肾  免疫治疗
DOI:
基金项目:
Therapeutic effect of immunosuppressant for adult polycystic kidney disease
齐隽,朱有华,闵志廉,王炜,王立明
()
Abstract:
Objective: To discuss the therapeutic effect of immunosuppresant for adult polycystic kidney disease (APDK). Methods: Collecting 24 cases of APKD patients undergone the renal transplantation for 1-8 years (mean time is 3.18 years). The checking items were waist pain,haematuria,hypertension and polycystic kidney size before and after renal transplantation. Immunosuppressants include cyclosporine, azathioprine and prednisone. Results: After transplantation, release of waist pain was most obvious; occurrence rate of haematuria decreased from 83.3%to 12.5%(P<0.01); hypertention did not change in 1 month but improved in 1 year (P<0.01); polycystic kidney size examined by B-ultrasound showed no difference and stayed in “steady” state. Conclusion: Immunosuppressants contribute to all the above improvements. APKD may be gene-depended immunodisease or immunity plays an important role in its pathogenesis. So immunosuppressant may be therapeutically effective for APKD.
Key words:  polycystic kidney  immunotherapy