Clinical study of individual application of different mycophenolic acid preparations in early renal transplantation
Objective To compare the clinical effects of mycophenolate mofetil(MMF)and mycophenolate sodium enteric-coated tablets(EC-MPS)in the early postoperative period after renal transplantation.Methods A retrospective analysis was performed on 329 kidney transplant recipients in our hospital,who were divided into MMF group(202 cases)and EC-MPS group(127 cases)according to different medications.Peripheral blood cells and estimated glomerular filtration rate(eGFR),the area under the curve of mycophenolic acid(MPA-AUC)compliance rate,the incidences of myelosuppression,acute rejection(AR),delayed recovery of transplanted renal function(DGF),gastrointestinal adverse reactions,and infection were compared between the two groups within 1 month after renal transplantation.Results There were no significant differences in the levels of peripheral blood white blood cells,lymphocytes,hemoglobin,and eGFR at 3,7,14,and 30 days after renal transplantation between the two groups(P＞0.05).At 3 days after transplantation,there was no statistical difference in platelets between the MMF group and EC-MPS group,but at 7 days,14 days,and 30 days after transplantation,the platelets in the MMF group were lower than those in EC-MPS group,with a statistical difference.The incidence of thrombocytopenia in 1 month between the two groups was 21.3%and 12.6%,respectively,with statistical differences(P＜0.05).In MMF group and EC-MPS group,the incidence of leukopenia was 10.40%and 12.6%,the incidence of AR was 16.8%and 17.3%,the incidence of DGF was 12.4%and 14.2%,the incidence of gastrointestinal adverse reactions was 6.9%and 6.30%,and the incidence of infection was 17.8%and 14.2%,respectively,with no statistical difference(P＞0.05).The compliance rate of MPA-AUC 7 days after renal transplantation was 55.9%and 41.7%in the MMF and EC-MPS groups,respectively,with statistical differences(P＜0.05).Conclusion In the early stage of renal transplantation,MMF has a stronger inhibitory effect on platelets than EC-MPS,and MMF has a higher compliance rate of MPA-AUC than EC-MPS.Therefore,it is nec-essary to select two mycophenolic acid preparations individually according to the immune risk of transplant recipi-ents and whether there is thrombocytopenia.
万方数据
维普
