MacDonald A S, Daloze P, Dandavino R, Jindal S, Bear L, Dossetor J B, Klassen J, Stiller C R, Lockwood B, Reeve C E
Ambulatory Care Centre, Victoria General Hospital Halifax, Nova Scotia, Canada.
Transplant Proc. 1987 Feb;19(1 Pt 3):1865-6.
Sixty-nine patients receiving Cs after cadaveric or LRD renal transplants were randomly allocated to receive prednisone or no prednisone beginning on the day of transplant. There were 36 in the prednisone group and 33 in the group assigned to no prednisone. Of these latter, only seven (21%) never received prednisone and an additional four had one short course for rejection episodes (11%). Of the remaining 22 who were placed on continuous steroids, only 12 met rejection criteria and either some or all of the remainder probably had Cs nephrotoxicity. The patient and graft survival were better but not statistically so in the no-prednisone group (97% v 89%) and (88% v 78%), and the number of infections was only half that of the prednisone-treated group (22% v 42%). A policy of withholding steroids except for rejection episodes does not prejudice graft or patient survival in Cs-treated patients.
69例接受尸体或活体亲属供肾移植后使用环孢素（Cs）的患者，在移植当天被随机分配接受泼尼松或不接受泼尼松治疗。泼尼松组有36例，未接受泼尼松组有33例。在未接受泼尼松组中，只有7例（21%）从未接受过泼尼松治疗，另外4例因排斥反应有过一个短疗程的治疗（11%）。在其余22例接受持续类固醇治疗的患者中，只有12例符合排斥标准，其余部分患者中部分或全部可能存在Cs肾毒性。未接受泼尼松组的患者和移植物存活率更高，但无统计学差异（97%对89%）和（88%对78%），感染率仅为泼尼松治疗组的一半（22%对42%）。除排斥反应外不使用类固醇的策略，对接受Cs治疗的患者的移植物或患者存活率无不利影响。
