CAJ | 학술논문

目的探讨肾移植受者因吗替麦考酚酯(MMF)相关胃肠道不良反应转换应用麦考酚钠肠溶片(EC-MPS)后对胃肠道相关生活质量的影响及使用EC-MPS的安全性、有效性.方法 41例肾移植受者在术后(46.3±17.1)个月时因MMF胃肠道不良反应而转换使用EC-MPS.转换前及转换后12周,采用胃肠道生活质量指数量表(GIQLI)进行评分,观察使用EC-MPS的安全性和有效性.结果转换前MMF剂量为(846.7±291.3)mg/d,转换后EC-MPS剂量为(639.5±186.4)mg/d.转换前GIQLI评分为(103.6±10.7)分,转换后12周为(118.3±15.1)分,二者比较,差异有统计学意义(P＜0.05).转换EC-MPS后,受者对EC-MPS的耐受性良好,未发生感染、急性排斥反应、移植肾功能丧失或死亡;转换前受者的血肌酐为(136.9±35.7)μmol/L,转换后为(128.4±40.8)μmol/L (P＞0.05).结论对于肾移植术后发生MMF胃肠道不良反应的受者,转换应用EC-MPS后,能明显减轻胃肠道的不良反应,生活质量获得较大改善,且EC-MPS的安全性和有效性均良好.
목적 탐토신이식수자인마체맥고분지(MMF)상관위장도불량반응전환응용맥고분납장용편(EC-MPS)후대위장도상관생활질량적영향급사용EC-MPS적안전성、유효성.방법 41례신이식수자재술후(46.3±17.1)개월시인MMF위장도불량반응이전환사용EC-MPS.전환전급전환후12주,채용위장도생활질량지수량표(GIQLI)진행평분,관찰사용EC-MPS적안전성화유효성.결과 전환전MMF제량위(846.7±291.3)mg/d,전환후EC-MPS제량위(639.5±186.4)mg/d.전환전GIQLI평분위(103.6±10.7)분,전환후12주위(118.3±15.1)분,이자비교,차이유통계학의의(P＜0.05).전환EC-MPS후,수자대EC-MPS적내수성량호,미발생감염、급성배척반응、이식신공능상실혹사망;전환전수자적혈기항위(136.9±35.7)μmol/L,전환후위(128.4±40.8)μmol/L (P＞0.05).결론 대우신이식술후발생MMF위장도불량반응적수자,전환응용EC-MPS후,능명현감경위장도적불량반응,생활질량획득교대개선,차EC-MPS적안전성화유효성균량호.
Objective To evaluate the effect of conversion from mycophenolat mofetil (MMF) to enteric-coated mycophenolate sodium (EC-MPS) on gastrointestine-related quality of life,as well as the safety and efficacy.Method A total of 41 renal transplant (RT) recipients were converted from MMF to EC-MPS (46.3 ± 17.1) months after the operation due to the gastrointestinal side effects of MMF,with a mean time of 46.3 months.Before the conversion and 12 weeks later,the patients were evaluated with Gastrointestinal Quality of Life Index (GIQLI) questionnaire,and the safety and efficacy were assessed.Result The average dose of MMF was 846.7 ± 291.3 mg/day before the conversion,with a mean dose of 639.5 ± 186.4 mg/day for EC-MPS.The total score of GIQLI was 103.6 ± 10.7 before the conversion,and 12 weeks after conversion 118.3 ± 15.1,with a statistical significance (P＜0.05).The safety of EC-MPS was excellent without infection,acute rejection episode,loss of allograft or death.The serum creatine was 136.9 ± 35.7 mol/L before conversion and 128.4± 40.8 mol/L after conversion (P ＞ 0.05).Conclusion For the RT patients with gastrointestinal side effects of MMF,conversion to EC-MPS could significantly alleviate gastrointestinal illness,and improve quality of life,with excellent safety and efficacy.