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肾移植术后妊娠期的免疫抑制药物治疗

[Immunosuppressive drug therapy during pregnancy after kidney transplantation].

作者信息

Kazimierczak Krzysztof, Kazimierczak Iwonna, Weyde Wacław, Zmonarski Sławomir, Gryboś Marian, Klinger Marian

机构信息

Katedra i Klinika Nefrologii i Medycyny Transplantacyjnej AM we Wrocławiu.

出版信息

Ginekol Pol. 2005 Jul;76(7):586-92.

Abstract

The authors expounded present state of knowledge concerning immunosuppressive drugs therapy during pregnancy after kidney transplantation. Pregnancy is uncommon in women with end-stage renal disease treated with dialysis and in most cases it ends with pregnancy failure. Resuming the normal function of the ovaries after kidney transplantation substantially increases the chances of conception and successful pregnancy. The immunosuppression scheme and dosage of drugs used in pregnant women are vital to both the normal course of pregnancy and delivery of a healthy child. Considering the safety of the fetus it is acceptable to use prednisone, azathioprine, cyclosporine and tacrolimus. Due to the necessity to administer immunosuppressive drugs in relatively small doses, an important factor conditioning the normal course of pregnancy is maintaining a 1- or 2-year interval between the kidney transplantation and the conception.

摘要

作者阐述了肾移植术后妊娠期免疫抑制药物治疗的现有知识状况。在接受透析治疗的终末期肾病女性中,妊娠并不常见,且在大多数情况下,妊娠以失败告终。肾移植后卵巢恢复正常功能会大幅增加受孕和成功妊娠的机会。孕妇使用的免疫抑制方案和药物剂量对于妊娠的正常进程以及健康婴儿的分娩都至关重要。考虑到胎儿的安全,使用泼尼松、硫唑嘌呤、环孢素和他克莫司是可以接受的。由于需要以相对小的剂量使用免疫抑制药物,肾移植与受孕之间保持1年或2年的间隔是妊娠正常进程的一个重要影响因素。

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