雷帕鸣是哪生产的

(sirolimus) is a new type of anti-lymphocyte drug mTOR inhibitor, developed and produced by Wyeth Company of the United States. As a new generation of immunosuppressants, its outstanding feature is that it has little nephrotoxicity. Since the drug is mainly metabolized in the liver and gastrointestinal tract through the cytochrome P450 system, more than 91% of the metabolites pass through the gastrointestinal tract, and about 2% are excreted through the skin, so its nephrotoxicity is minimal.

Foreign data confirm that sirolimus (rapamin) is not nephrotoxic, and its emergence provides the possibility of reducing or even removing CsA. Studies have shown that among patients who continued to use CsA for 1 year after surgery, 64% of patients developed CAN and 90% had higher Banff scores. However, among those who used sirolimus and Pred, only 36% of patients developed CAN and 32% had higher Banff scores. At present, more and more literature confirms that removal of CNI can significantly improve the histological changes of the transplanted kidney, improve the function of the transplanted kidney, and alleviate the patient's hypertension and hyperuricemia.

Due to the strong immunosuppressive effect of sirolimus, the CsA used in combination with sirolimus during initial treatment is reduced by about one-third compared with the conventional dose. As the postoperative time prolongs, while maintaining a constant concentration of sirolimus (generally above 5 ug/L), the dosage of CsA can be further gradually reduced to achieve the purpose of avoiding rejection and reducing CsA nephrotoxicity.

A retrospective study showed that sirolimus can significantly prolong the recovery time of renal function in patients with delayed renal allograft recovery. In a domestic study, 6 patients experienced delayed recovery of kidney transplant function after surgery. Although all kidney functions returned to normal (Cr<130 umol/L), 1 patient did not urinate until the 80th day after surgery, suggesting that it may have a certain impact on the recovery of kidney function in patients with delayed kidney transplant function. Therefore, it is recommended that it should be used with caution when patients are anuric.

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