Kosch Markus, Hausberg Martin, Suwelack Barbara
of Internal Medicine D. University of Muenster, Germany.
Transplantation. 2003 Nov 27;76(10):1516-9. doi: 10.1097/01.TP.0000092521.57633.BD.
Whether withdrawal of calcineurin inhibitors has a beneficial effect on disturbed endothelial function and large artery distensibility in renal transplant recipients is not clear. We studied the effects of cyclosporine A (CsA) withdrawal on arterial compliance and endothelium-dependent flow-mediated vasodilatation (FMD) in a prospective, randomized trial; 24 renal transplant recipients receiving mycophenolate mofetil were randomized to withdrawal (n=12) or continuation of CsA (n=12). At baseline and after 6 months, carotid and brachial artery distensibility coefficients and brachial FMD were measured. Brachial distensibility coefficients increased in both groups (withdrawal: 11.1+/-1-14.9+/-2 10(-3)/kPa, continuation: 10.7+/-1-15.2+/-3 10(-3)/kPa, P<0.05, respectively). However, there was no significant effect of treatment on carotid artery distensibility coefficients, FMD, or graft function. Withdrawal of CsA failed to improve carotid artery distensibility or brachial FMD in patients after renal transplantation. Our data indicate that CsA treatment does not contribute significantly to endothelial dysfunction observed in renal transplant recipients.
钙调神经磷酸酶抑制剂的撤药对肾移植受者内皮功能紊乱和大动脉弹性是否具有有益作用尚不清楚。我们在一项前瞻性随机试验中研究了环孢素A（CsA）撤药对动脉顺应性和内皮依赖性血流介导的血管舒张（FMD）的影响；24例接受霉酚酸酯治疗的肾移植受者被随机分为撤药组（n = 12）或继续使用CsA组（n = 12）。在基线期和6个月后，测量颈动脉和肱动脉的弹性系数以及肱动脉FMD。两组的肱动脉弹性系数均增加（撤药组：11.1±1-14.9±2×10⁻³/kPa，继续用药组：10.7±1-15.2±3×10⁻³/kPa，P均<0.05）。然而，治疗对颈动脉弹性系数、FMD或移植肾功能无显著影响。肾移植术后患者停用CsA未能改善颈动脉弹性或肱动脉FMD。我们的数据表明，CsA治疗对肾移植受者中观察到的内皮功能障碍没有显著影响。
