普乐可复联合护肝片治疗肝移植后轻、中度急性排斥反应的疗效分析

目的: 评价普乐可复(FK506) 联合护肝片治疗肝移植后轻、中度急性排斥反应的临床疗效。方法: 将47 例肝移植后出现轻、中度急性排斥反应的移植受者, 分为两组:对照组24 例, 试验组23例。试验组加用护肝片治疗, 3 片/次, 口服, 2 次/d(同FK506 一起服用) 。并于服药后第6 、14 天后复查FK506 血药浓度及肝、肾功能。结果: 试验组加用护肝片后患者的FK506 血药浓度明显提高(P <0.01), 与对照组比较有统计学差异(P <0.01) 。试验组FK506 联合护肝片治疗后的肝功能指标ALT 、AST 、TBIL 、DBIL 均较治疗前明显下降(P <0.01), 和对照组比较差异有统计学意义(P <0.05) 。其中, 试验组治疗后第6 天的显效率达47.83 %, 总有效率达91.30 %, 显著高于对照组(P <0.05) ;治疗后第14 天, 试验组的显效率较对照组提高23.91 %。FK506 联合护肝片治疗对肾功能指标无明显影响。结论: FK506 联合护肝片治疗肝移植后轻、中度急性排斥反应安全、有效。其中, 护肝片不仅可促进肝功能恢复, 还可明显提高FK506 血药浓度, 减少FK506 的用量。

Evaluation of tacrolimus combining with liver-aid tablet in the treatment of acute rejection after liver transplantation

AIM: To evaluate the effects of tacrolimus (FK506) combining with liver-aid tablet in treatment of acute rejection after liver transplantation. METHODS: Forty-seven cases with mild to moderate acute rejection after liver transplantation were reviewed, 23 in FK506 combining with liver-aid tablet treatment group, 24 in FK506 without liver-aid tablet control group. Besides treatments with FK506, 23 patients with acute rejection in the treatment group were given liver-aid tablet three pills twice daily. To analyze blood concentration of FK506 biochemically and levels of liver function on the sixth day, fourteenth day after treatments, respectively. RESULTS: The blood concentration of FK506 in the treatment group had a significantly increase as compared with the control group (P <0.01). Liver functions of the patients in the treatment group were improved significantly (P <0.05) on both the sixth day and fourteenth day. Levels of alanine aminotransferase (ALT), aspartate transferase (AST), total bilirubin (TBIL) and direct bilirubin (DBIL) in the treatment group were all significantly lower than those of the control group. The effective rate in treatment group on the 6th day was 47.83 %, and the total effective rate was 91.30 %.Therapeutic effects in the treatment group were significantly better than that in the control group (P < 0.05). CONCLUSION: FK506 combining with liver-aid tablet is safe and effective for the treatment of acute rejection after liver transplantation. Liver-aid tablet is useful not only for promoting liver function, but also for increasing FK506 concentration, as well as for saving money on FK506.