Lausten G S, Jensen J S, Olgaard K
Department of Orthopedics, University of Copenhagen, Denmark.
Acta Orthop Scand. 1988 Dec;59(6):650-4. doi: 10.3109/17453678809149417.
The cumulated risk of developing necrosis of the femoral head following renal transplantation was 42/374 in patients treated with steroids and azathioprine, and 4/124 in patients treated with cyclosporine-A and a reduced dose of steroids. 29 of the osteonecrosis cases were bilateral, with the time lapse between the two sides rarely exceeding 6 months. The reduction in the rate of osteonecrosis paralleled a reduction in the number of rejection episodes during the first month after transplantation and in the cumulated dose of steroids 1 month and 1 year after transplantation. We concluded that the risk of femoral head necrosis following renal transplantation is reduced by using cyclosporin-A for immunosuppression, which caused less rejection episodes and consequently a reduction in steroid medication.
接受类固醇和硫唑嘌呤治疗的肾移植患者发生股骨头坏死的累积风险为374例中有42例，而接受环孢素A和减量类固醇治疗的患者为124例中有4例。29例骨坏死病例为双侧性，两侧发病时间间隔很少超过6个月。骨坏死发生率的降低与移植后第一个月排斥反应发作次数的减少以及移植后1个月和1年时类固醇累积剂量的减少相一致。我们得出结论，肾移植后使用环孢素A进行免疫抑制可降低股骨头坏死的风险，因为其引起的排斥反应发作较少，从而减少了类固醇药物的使用。
