雷帕鸣是治什么病

(sirolimus) has almost no nephrotoxicity compared with standard-dose calcineurin inhibitors, and has unique immunological advantages in inducing tolerance and improving kidney transplant function. At present, this drug has been widely used in the treatment of kidney transplant patients.

In order to observe the clinical effect of using sirolimus (i.e., rapamin) instead of calcineurin inhibitors to treat calcineurin inhibitor nephrotoxicity and chronic allograft nephropathy in kidney transplant patients at different serum creatinine levels, a domestic study selected patients diagnosed with calcineurin inhibitor chronic nephrotoxicity and chronic allograft nephropathy after kidney transplantation. According to the pre-conversion serum creatinine <-220 μmol/L and serum creatinine >220 μmol/L, each was divided into calcineurin inhibitor nephrotoxicity group, chronic allograft nephropathy group and calcineurin inhibitor maintenance group; the first two groups converted the calcineurin inhibitor in the original immunosuppression regimen to sirolimus, with a total of 53 patients in the conversion group, and a total of 28 patients with calcineurin inhibitor maintenance as the control group, who were followed up for 3 years. The serum creatinine levels and incidence of adverse events in each group at different follow-up time points were dynamically observed, and a total of 9 transplanted kidney biopsy cases were performed at the end of follow-up.

The results showed that before the conversion, the serum creatinine value of the calcineurin inhibitor nephrotoxicity group and the chronic allograft nephropathy group was significantly lower than before the conversion at the 24th and 36th months of follow-up (P<0.05). The serum creatinine of the calcineurin inhibitor maintenance group showed a slow crawling increase higher than that of the first two groups (P<0.05). The serum creatinine in the calcineurin inhibitor nephrotoxicity group decreased significantly after conversion (P<0.05); the serum creatinine in the latter two groups increased slowly after conversion (P<0.05). The main adverse events after conversion included mild anemia (30.2%), hyperlipidemia (35.8%), and low leukocytes (22.6%).

Finally, it was concluded that after renal transplantation, the blood creatinine creeps up and the rapamin (i.e., sirolimus) regimen has a significant effect. Before the conversion, a puncture biopsy is performed to confirm calcineurin inhibitor nephrosis or chronic transplant kidney nephropathy, and the serum creatinine level is used to comprehensively judge whether to perform conversion treatment. Pay attention to monitoring blood lipid levels: conversion should be carried out before serious damage to the transplanted kidney function occurs. Early conversion will benefit the patient more.

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