JACC:西罗莫司缓解心脏移植后免疫反应更佳

2018-02-09 MedSci MedSci原创

既往有报道称西罗莫司(SRL)在缓解心脏移植后的移植物血管病(CAV)方面的效果要优于钙调神经磷酸酶抑制剂(CNI),然而缺乏远期的疗效报道。本研究旨在评估用SRL代替CNI作为维持治疗心脏移植后的CAV远期的有效性和安全性。本研究纳入了402例心脏移植后的患者,这些患者有的仅接受CNI治疗(n = 134),有的用SRL代替了CNI作为一级免疫抑制预防治疗(n = 268),CAV通过冠脉血管内

既往有报道称西罗莫司(SRL)在缓解心脏移植后的移植物血管病(CAV)方面的效果要优于钙调神经磷酸酶抑制剂(CNI),然而缺乏远期的疗效报道。本研究旨在评估用SRL代替CNI作为维持治疗心脏移植后的CAV远期的有效性和安全性。

本研究纳入了402例心脏移植后的患者,这些患者有的仅接受CNI治疗(n = 134),有的用SRL代替了CNI作为一级免疫抑制预防治疗(n = 268),CAV通过冠脉血管内超声进行评估。结果发现,与CNI相比,接受SRL治疗的患者斑块体积和斑块指数的进展均明显缓解,经过术后平均8.9年时间的随访,患者的全因死亡率为25.6%,在SRL治疗组中要更低,并且CAV相关不良事件的发生率也要更低。此外,进一步分析发现,越早用SRl替代CNI治疗,CAV缓解的程度就越高。

研究结果显示,西罗莫司在缓解心脏移植后的移植物血管病方面要明显优于钙调神经磷酸酶抑制剂。

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    2018-02-09 hbwxf
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