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接受增殖信号抑制剂(依维莫司)或钙调神经磷酸酶抑制剂(他克莫司)治疗的移植患者的肾移植功能、脂质代谢紊乱以及血糖和血红蛋白浓度的比较

Comparison of Kidney Transplant Function, Lipid Metabolism Disorders, and Glucose and Hemoglobin Concentration in Transplant Patients Treated With Proliferation Signal Inhibitor (Everolimus) or Calcineurin Inhibitor (Tacrolimus).

作者信息

Sułowicz Joanna, Cieniawski Dominik, Ignacak Ewa, Bętkowska-Prokop Alina, Kuźniewski Marek, Sułowicz Władysław

机构信息

Department of Dermatology, Jagiellonian University, Medical College, Kraków, Poland.

Department of Nephrology, Jagiellonian University, Medical College, Kraków, Poland.

出版信息

Transplant Proc. 2020 Oct;52(8):2347-2351. doi: 10.1016/j.transproceed.2020.02.122. Epub 2020 Apr 16.

Abstract

INTRODUCTION

After kidney transplantation (KTx) in patients with diagnosed cancers, calcineurin inhibitor tacrolimus (TAC) is replaced by sirolimus or everolimus (EV).

OBJECTIVE

The objective of the study was to compare the lipid metabolism parameters, KTx function, and glucose and hemoglobin (Hgb) levels in patients treated with EV to those on TAC.

MATERIAL AND METHODS

The retrospective study included 114 patients: 54 (17 women and 37 men) aged 57.6 years (18-77 years) treated with EV and 60 (18 women and 42 men) aged 49.6 years (20-77 years) treated with TAC as a control group. Their total cholesterol (TC), triglycerides (TG), fasting glucose (FG), serum creatinine (SCr), Hgb, and estimated glomerular filtration rate (eGFR) were assessed. In the patients treated with EV, the above values were evaluated before conversion, as well as 12 and 24 months following the switch and were evaluated once in the group treated with TAC.

RESULTS

In the EV-treated group, the mean preconversion values after 12 and 24 months were as follows: TC 5.06, 6.59, and 5.98 mmol/L; TG 1.90, 2.48, and 2.20 mmol/L; FG 94.95, 97.85, and 104.05 mg/dL; SCr 1.46, 1.44, and 1.56 mg/dL; Hgb 12.46, 12.83, and 13.36 g/dL; and eGFR 50.3, 50.6, and 50.5 mL/min/1.73 m. In the patients on TAC, the authors obtained the following values: TC 4.6 mmol/L; TG 1.87 mmol/L; glucose 104.13 mg/dL; SCr 1.51 mg/dL; Hgb 13.96 g/dL; and eGFR 56.6 mL/min/1.73 m.

CONCLUSIONS

After conversion from TAC to EV, increased values of TC and TG were observed after 1 year, while the increased values of TC, TG, SCr, Hgb, and FG were observed after 2 years.

摘要

引言

在已确诊癌症的患者进行肾移植(KTx)后,钙调神经磷酸酶抑制剂他克莫司(TAC)会被西罗莫司或依维莫司(EV)取代。

目的

本研究的目的是比较接受依维莫司治疗的患者与接受他克莫司治疗的患者的脂质代谢参数、肾移植功能以及血糖和血红蛋白(Hgb)水平。

材料与方法

这项回顾性研究纳入了114例患者:54例(17名女性和37名男性),年龄57.6岁(18 - 77岁),接受依维莫司治疗;60例(18名女性和42名男性),年龄49.6岁(20 - 77岁),作为对照组接受他克莫司治疗。评估了他们的总胆固醇(TC)、甘油三酯(TG)、空腹血糖(FG)、血清肌酐(SCr)、Hgb和估计肾小球滤过率(eGFR)。在接受依维莫司治疗的患者中,在转换治疗前以及转换后12个月和24个月评估上述值,而在接受他克莫司治疗的组中仅评估一次。

结果

在接受依维莫司治疗的组中,转换治疗前、12个月和24个月后的平均数值如下:TC分别为5.06、6.59和5.98 mmol/L;TG分别为1.90、2.48和2.20 mmol/L;FG分别为94.95、97.85和104.05 mg/dL;SCr分别为1.46、1.44和1.56 mg/dL;Hgb分别为12.46、12.83和13.36 g/dL;eGFR分别为50.3、50.6和50.5 mL/min/1.73 m²。在接受他克莫司治疗的患者中,得到的数值如下:TC为4.6 mmol/L;TG为1.87 mmol/L;血糖为104.13 mg/dL;SCr为1.51 mg/dL;Hgb为13.96 g/dL;eGFR为56.6 mL/min/1.73 m²。

结论

从他克莫司转换为依维莫司后,1年后观察到TC和TG值升高,而2年后观察到TC、TG、SCr、Hgb和FG值升高。

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