Azevedo Luiz Sergio, Castro Maria Cristina R, Paula Flavio J, Ianhez Luiz Estevam, David-Neto Elias
Renal Transplantation Unit, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, SP, Brazil.
Rev Inst Med Trop Sao Paulo. 2005 May-Jun;47(3):143-5. doi: 10.1590/s0036-46652005000300005. Epub 2005 Jul 12.
Pneumocystis carinii pneumonia (PCP) is usually prevented in transplanted patients by prophylactic trimethoprim-sulfamethoxazol (TMS). Mycophenolate mofetil (MMF) has been shown to have a strong protective effect against PCP in rats. This effect is also suggested in humans by the absence of PCP in patients receiving MMF. After January 1998 MMF has been used with no TMS prophylaxis in renal transplanted patients. In azathioprine (AZA) treated patients TMS prophylaxis was maintained. The incidence of PCP was analyzed in both groups. Data were collected in order to have a minimum 6-month follow-up. Two hundred and seventy-two patients were eligible for analysis. No PCP occurred either in patients under MMF without TMS prophylaxis nor in patients under AZA. MMF may have an effective protective role against PCP as no patient under MMF, despite not receiving TMS coverage, developed PCP. A larger, controlled, trial is warranted to consolidate this information.
通常通过预防性使用甲氧苄啶 - 磺胺甲恶唑（TMS）来预防移植患者发生卡氏肺孢子虫肺炎（PCP）。已证明霉酚酸酯（MMF）对大鼠的PCP具有强大的保护作用。接受MMF治疗的患者未发生PCP，这在人类中也提示了这种作用。1998年1月以后，肾移植患者在未使用TMS预防的情况下使用了MMF。在接受硫唑嘌呤（AZA）治疗的患者中维持TMS预防。分析了两组患者的PCP发生率。收集数据以进行至少6个月的随访。272例患者符合分析条件。在未接受TMS预防的MMF治疗患者和接受AZA治疗的患者中均未发生PCP。尽管未接受TMS覆盖，但接受MMF治疗的患者均未发生PCP，因此MMF可能对PCP具有有效的保护作用。有必要进行一项更大规模的对照试验来巩固这一信息。
