Khosroshahi H T, Asghari A, Estakhr R, Baiaz B, Ardalan M R, Shoja M M
Department of Nephrology, Dialysis and Renal Transplantation, Kidney Transplantation Center, Imam Hospital, Tabriz University of Medical Sciences, Daneshgah St. Tabriz, Iran.
Transplant Proc. 2006 Sep;38(7):2077-9. doi: 10.1016/j.transproceed.2006.06.043.
Azathioprine (AZA) and mycophenolate mofetil (MMF) are major immunosuppressants used to prevent rejection following renal transplantation. Bone marrow suppression is a potential adverse effect of these agents manifesting itself as leukopenia, thrombocytopenia, and anemia. The aim of this study was to compare the effects of AZA versus MMF immunosuppressive regimens on the erythropoietic system of renal transplant recipients within 6 months after transplantation.
Eighty kidney allograft recipients who were on AZA (n = 40) or MMF (n = 40) plus cyclosporine and prednisolone were enrolled in this study. Hematologic parameters included red blood cell counts, hemoglobin (Hb), hematocrit, mean corpuscular volume, mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) and were measured before and at 1 week, as well as 1 and 6 months posttransplantation. Plasma erythropoietin level was measured at the end of 6 months. Statistical analysis was performed with Student t test; a P value less than .05 was considered significant.
There was no significant difference between the two groups regarding red blood cell counts. High Hb level was noted at 1 and 6 months posttransplantation among patients who received MMF. MCH and MCHC were higher among patients on MMF compared with those on AZA at 1 week and 1 month posttransplant. Although the mean plasma erythropoietin levels in AZA-treated patients were higher than those of MMF-treated patients, the trend did not reach statistical significance (P = .066).
MMF administration was apparently associated with a higher level of hemoglobin compared with AZA among renal allograft recipients with good graft function at 6 months posttransplantation.
硫唑嘌呤（AZA）和霉酚酸酯（MMF）是用于预防肾移植后排斥反应的主要免疫抑制剂。骨髓抑制是这些药物的一种潜在不良反应，表现为白细胞减少、血小板减少和贫血。本研究的目的是比较AZA与MMF免疫抑制方案对肾移植受者移植后6个月内红细胞生成系统的影响。
本研究纳入了80例接受AZA（n = 40）或MMF（n = 40）联合环孢素和泼尼松龙治疗的肾移植受者。血液学参数包括红细胞计数、血红蛋白（Hb）、血细胞比容、平均红细胞体积、平均红细胞血红蛋白（MCH）和平均红细胞血红蛋白浓度（MCHC），在移植前、移植后1周、1个月和6个月进行测量。在6个月末测量血浆促红细胞生成素水平。采用Student t检验进行统计分析；P值小于0.05被认为具有统计学意义。
两组之间的红细胞计数没有显著差异。接受MMF治疗的患者在移植后1个月和6个月时Hb水平较高。与接受AZA治疗的患者相比，接受MMF治疗的患者在移植后第1周和第1个月时MCH和MCHC更高。虽然接受AZA治疗的患者的平均血浆促红细胞生成素水平高于接受MMF治疗的患者，但该趋势未达到统计学意义（P = 0.066）。
在移植后6个月时，对于移植肾功能良好的肾移植受者，与AZA相比，使用MMF明显与更高的血红蛋白水平相关。
