Kootte A M, Lensen L M, van Es L A, Paul L C
Department of Medicine, University Hospital, Leiden, The Netherlands.
Transplantation. 1988 Nov;46(5):677-80. doi: 10.1097/00007890-198811000-00010.
The long-term results of conversion of cyclosporine to azathioprine and those of continuous CsA therapy were evaluated in a prospective study of 66 renal transplant patients who had been randomly assigned to each treatment group at 3 months following transplantation. The start point of the study was thus at 3 months posttransplant; no differences in the three-year patient and graft survival were found; these consisted of 97% and 94% in the converted group and 100% and 94% in the nonconverted group, respectively. The incidence of one or more antirejection treatments did not differ between the two groups at 3-12 months (16% vs. 17%) or after 12 months (12% vs. 9%). The incidence of hypertension at different intervals ranged from 79% to 100% in the group on continuous CsA therapy versus 50 to 58% in the converted patients. The degree of proteinuria in the 2 groups was not different at at 12 months. At 24 and 36 months the proteinuria (g/24 hr) was higher in the converted group (0.51 +/- 0.18 and 0.53 +/- 0.13; mean +/- SEM) versus the CsA group (0.15 +/- 0.04 and 0.21 +/- 0.09). At 3 years, the mean creatinine clearance for the patients converted to Aza was higher than that found for the continuously CsA-treated patients (67 +/- 8 and 59 +/- 6 ml/min; mean +/- SEM). This study shows that early CsA conversion to Aza gives a slightly better 3-year graft function, although not significantly different, compared with continuous CsA therapy without differences in patient or graft survival.
在一项前瞻性研究中，对66例肾移植患者进行了评估，这些患者在移植后3个月被随机分配到每个治疗组，以观察环孢素转换为硫唑嘌呤的长期结果以及持续使用环孢素治疗的结果。因此，研究的起点是移植后3个月；在三年的患者和移植物存活率方面未发现差异；转换组分别为97%和94%，未转换组分别为100%和94%。在3 - 12个月（16%对17%）或12个月后（12%对9%），两组接受一次或多次抗排斥治疗的发生率没有差异。持续使用环孢素治疗组不同时间段的高血压发生率在79%至100%之间，而转换患者组为50%至58%。两组在12个月时蛋白尿程度无差异。在24个月和36个月时，转换组的蛋白尿（克/24小时）较高（0.51±0.18和0.53±0.13；平均值±标准误），而环孢素组为（0.15±0.04和0.21±0.09）。在3年时，转换为硫唑嘌呤的患者的平均肌酐清除率高于持续接受环孢素治疗的患者（67±8和59±6毫升/分钟；平均值±标准误）。这项研究表明，与持续使用环孢素治疗相比，早期将环孢素转换为硫唑嘌呤可使3年移植物功能略好，尽管差异不显著，且患者或移植物存活率无差异。
