雷帕鸣效果好不好

(sirolimus, sirolimus) is a target of rapamycin inhibitor (mTORI) used in clinical kidney transplantation in recent years. Similar to tacrolimus, sirolimus binds to cytoplasmic protein (i.e., FKBP), but the sirolimus-FKBP complex does not inhibit calcineurin, avoiding the nephrotoxicity of tacrolimus.

Studies have shown that although the incidence of AR in recipients who use sirolimus after kidney transplantation is higher than that in recipients who use tacrolimus, the use of sirolimus can improve postoperative renal graft function and reduce the adverse reactions caused by tacrolimus.

In order to explore the effectiveness and safety of sirolimus in preventing acute rejection after kidney transplantation, a domestic study included 36 kidney transplant patients. 31 patients started taking sirolimus immediately after surgery, of which 30 cases were treated with reduced-dose cyclosporine A (CsA), sirolimus and prednisone to prevent rejection, and 1 case was treated with other drugs. Crolimus, sirolimus and prednisone were used to prevent rejection; 5 cases had CsA replaced with sirolimus due to adverse reactions within 1 month after surgery, 1 case was changed to reduced dose CsA, sirolimus and prednisone, 3 cases were changed to sirolimus, mycophenolate mofetil and prednisone, and 1 case was changed to sirolimus and prednisone.

Observe the kidney transplant function and the occurrence of acute rejection, infection, delayed recovery of kidney transplant function (DGF), etc. Results After 18 to 40 months of follow-up, 2 cases lost transplanted kidney function and resumed hemodialysis. The transplanted kidneys survived for 1.6 and 1.8 years respectively; 3 cases had serum creatinine >200 μmol/L and developed chronic allograft nephropathy; 31 cases had good transplanted kidney function. Acute rejection occurred in 4 cases, which was reversed after methylprednisolone pulse treatment; infection occurred in 8 cases, and all recovered after anti-infection treatment; DGF occurred in 6 cases, and the immunosuppressive regimen was not adjusted, and urinary function resumed 14 to 80 days after surgery. Adverse reactions after sirolimus include increased blood lipids, leukopenia, and proteinuria.

Finally, it was concluded that the combination of (sirolimus) with reduced-dose CsA and prednisone after kidney transplantation can achieve better immunosuppressive effects.

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