2019 年第 7 期 第 14 卷

他克莫司联合百令胶囊对肝移植术后患者空腹血糖和肾功能的影响

Effect of tacrolimus combined with Bailing capsules on fasting blood glucose and renal function in patients after liver transplantation

作者：谢放王璐陈德喜张静林明华蔡泽丁越超石英庞丽君林栋栋

英文作者：

单位：100069北京市肝病研究所科研部（谢放、陈德喜、林明华、石英、庞丽君）；100069首都医科大学附属北京佑安医院外科（王璐、张静、蔡泽、丁越超、林栋栋）

英文单位：

关键词：肝移植；他克莫司；血糖；肾功能

英文关键词：

• 摘要：

• 【摘要】目的    评估他克莫司联合百令胶囊对肝移植术后患者空腹血糖和肾功能的影响。方法    收集2007年1月至2011年12月首都医科大学附属北京佑安医院进行肝移植的73例患者的临床资料。肝移植术后3个月内均采用激素和他克莫司联合治疗，依据3个月后用药的不同分为对照组（13例）和观察组（60例），对照组采用他克莫司治疗；观察组采用他克莫司和百令胶囊联合治疗。在术后1、2、3年分别对患者的血糖和肝肾功能等指标进行评估分析。结果    观察组术后2、3年血尿素氮和血肌酐水平均明显低于对照组（均P<0.05）。观察组肝移植术后1、2、3年空腹血糖、血尿素氮和血肌酐差异均无统计学意义（均P>0.05），术后3年血尿酸明显高于术后1年［（389±120）μmol/L比（316±118）μmol/L］（P<0.01）。观察组术后2、3年高尿酸血症发生率及男性高尿酸血症发生率均明显高于术后1年(均P<0.05)。结论    他克莫司联合百令胶囊治疗肝移植术后患者，可显著改善其血尿素氮和血肌酐水平，延缓慢性肾功能衰竭的进展，但不能显著改善血糖和血尿酸的升高。二者联用无明显不良反应，安全性好。

• 【Abstract】Objective    To evaluate the effect of tacrolimus combined with Bailing capsules on fasting blood glucose and renal function in patients after liver transplantation. Methods    Clinical data of 73 patients who had liver transplantation from January 2007 to December 2011 in Beijing YouAn Hospital, Capital Medical University were analyzed. All patients were treated with tacrolimus and hormones in the first 3 months after surgery. Three months later, they were divided into control group(13 cases) treated with tacrolimus and observation group(60 cases) treated with tacrolimus plus Bailing capsules. Blood glucose, liver and kidney function indexes were analyzed 1, 2, 3 years after surgery. Results    Levels of fasting blood glucose, urea nitrogen and creatinine in observation group were significantly lower than those in control group at 2 and 3 years after surgery(all P<0.05). In observation group, there was no significant changes of fasting blood glucose, blood urea nitrogen and creatinine levels in 1, 2, 3 years after surgery（all P>0.05）; blood uric acid level at 3 years was significantly higher than that at 1 year after surgery［（389±120）μmol/L vs （316±118）μmol/L］（P<0.01）. The total incidence of hyperuricemia and the incidence of hyperuricemia in males at 2, 3 years were significantly higher than those at 1 year after surgery in observation group(all P<0.05). Conclusions    Tacrolimus combined with Bailing capsules treating patients after liver transplantation can effectively increase blood urea nitrogen and creatinine levels, delay the progression of chronic renal failure, but it shows no significant effect on blood glucose and uric acid. The combined medication shows no obvious adverse reaction.