van Dorp W T, Kootte A M, van Gemert G W, van Es L A, Paul L C
Department of Nephrology, University Hospital, Leiden, The Netherlands.
Scand J Infect Dis. 1989;21(1):75-80. doi: 10.3109/00365548909035683.
The incidence and severity of infectious complications were retrospectively investigated in 80 renal transplant patients who had been selected randomly to receive either cyclosporine (CsA) or azathioprine (Aza) in combination with low doses of corticosteroids. In the first 3 months, the incidence of infections was twice as high in the Aza-treated patients (p less than 0.05) which was due to an increase of predominantly minor infections. This increased incidence of infections was related to the increased number of anti-rejection treatments in the Aza-treated group. The types of infections were not different between the 2 treatment groups nor did the incidence of CMV infections differ. In the CsA-treated group, patients were randomly assigned at 3 months after transplantation to either continuation of CsA therapy or conversion to Aza. After conversion a small but not significant increase in predominantly minor infections was observed, which may be attributable to increased doses of corticosteroids given during the conversion. We conclude that in the first 3 months following transplantation, CsA therapy is associated with significantly less infections than Aza therapy; following conversion of CsA to Aza at 3 months only a small increase in the infection incidence is found.
回顾性调查了80例随机选择接受环孢素（CsA）或硫唑嘌呤（Aza）联合小剂量皮质类固醇治疗的肾移植患者感染并发症的发生率和严重程度。在最初3个月，接受Aza治疗的患者感染发生率是接受CsA治疗患者的两倍（p<0.05），这主要是由于轻度感染增加所致。Aza治疗组感染发生率增加与抗排斥治疗次数增多有关。两个治疗组的感染类型无差异，巨细胞病毒（CMV）感染发生率也无差异。在CsA治疗组，患者在移植后3个月被随机分配继续CsA治疗或转换为Aza治疗。转换后观察到轻度感染有小幅但不显著的增加，这可能归因于转换期间给予的皮质类固醇剂量增加。我们得出结论，在移植后的前3个月，CsA治疗与感染显著少于Aza治疗相关；3个月时将CsA转换为Aza后，感染发生率仅小幅增加。
