Woodside K J, Nichols S D, Hunter G C, Gugliuzza K K, Daller J A
Department of Surgery, Division of Transplantation, University of Texas Medical Branch, Galveston, Texas 77555-0534, USA.
Transplant Proc. 2005 May;37(4):1877-9. doi: 10.1016/j.transproceed.2005.02.095.
While cyclosporine and tacrolimus use results in similar renal graft survival, the side effect profiles of the drugs are substantially different. We examined the electrolyte and lipid alterations that occurred in our patient population following conversion from cyclosporine to tacrolimus.
Data for electrolytes, lipid profile, and immunosuppression were analyzed from 98 patients with kidney or kidney-pancreas transplants who were converted from cyclosporine to tacrolimus between October 1994 and June 2001. Results, expressed as mean +/- SEM, were compared to baseline values using the Wilcoxon signed-rank test (P < .05 considered significant).
Among these patients, there were 56 men, 42 women, 75 primary transplants, 15 repeat transplants, and 26 multiorgan transplants. The mean time to tacrolimus conversion was 769 +/- 122 days. Creatinine, BUN, and glucose improved after conversion to tacrolimus. Surprisingly, cholesterol, low-density lipoproteins, and high-density lipoproteins levels were not significantly altered, although triglyceride levels demonstrated a significant difference at 1 year.
Significant improvements in creatinine and BUN were observed following conversion from cyclosporine to tacrolimus. While hypomagnesemia was also seen, there was surprisingly little alteration in lipid profile.
虽然使用环孢素和他克莫司可使肾移植存活率相似，但这两种药物的副作用谱却有很大差异。我们研究了在我们的患者群体中，从环孢素转换为他克莫司后发生的电解质和脂质变化。
分析了1994年10月至2001年6月期间从环孢素转换为他克莫司的98例肾移植或肾胰联合移植患者的电解质、血脂谱和免疫抑制数据。结果以均值±标准误表示，使用Wilcoxon符号秩检验与基线值进行比较（P <.05认为有统计学意义）。
在这些患者中，有56名男性、42名女性，75例初次移植、15例再次移植和26例多器官移植。转换为他克莫司的平均时间为769±122天。转换为他克莫司后，肌酐、尿素氮和血糖有所改善。令人惊讶的是，胆固醇、低密度脂蛋白和高密度脂蛋白水平没有显著变化，尽管甘油三酯水平在1年时显示出显著差异。
从环孢素转换为他克莫司后，肌酐和尿素氮有显著改善。虽然也出现了低镁血症，但脂质谱的变化出人意料地小。
