Lipid abnormalities in stable liver transplant recipients - effects of cyclosporin, tacrolimus, and steroids
Lipid abnormalities in stable liver transplant recipients - effects of cyclosporin, tacrolimus, and steroids
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DOI：
10.1007/s001470050117
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发表时间：
1998-03-01
影响因子：
3.1
通讯作者：
del Palacio, A
中科院分区：
文献类型：
--
作者：
Fernandez-Miranda, C;Guijarro, C;del Palacio, A
血脂异常在肝移植后很常见，但其潜在的机制很大程度上是未知的。我们研究了27名肝移植受者随机接受环孢素(CPA，n=14)或他克莫司(n=13)的血脂谱，并与20名健康、匹配的对照组进行了比较。在移植前，患者表现出低总和低密度脂蛋白胆固醇(与对照组相比)，并在移植后不久，即3个月后升高。移植后18个月，总胆固醇和低密度脂蛋白水平下降到移植前水平，但接受环磷酰胺治疗的患者倾向于保持更高水平。然而，在那个时候，强的松治疗在接受CyA治疗的患者中比接受他克莫司治疗的患者更普遍，并完全解释了胆固醇水平的差异。事实上，无论接受何种治疗，未接受强的松治疗的患者比接受强的松治疗的患者和对照组的胆固醇水平更低。我们得出结论，强的松治疗，而不是CyA或他克莫司免疫抑制，似乎是胆固醇水平升高的主要决定因素。
Dyslipidemia is common after liver transplantation, but the underlying mechanisms are largely unknown. We studied the lipid profile of 27 liver transplant recipients randomized to receive either cyclosporin (CpA, n = 14) or tacrolimus (n = 13) and compared them with 20 healthy, matched controls. Before transplantation, patients presented low total and low-density lipoprotein (LDL) cholesterol (as compared to controls) that increased shortly, i.e., 3 months, after transplantation. Eighteen months post-transplantation, total and LDL cholesterol levels decreased to pretransplant values but tended to remain higher in CyA-treated patients. However, at that time, prednisone treatment was more prevalent among CyA-treated than tacrolimus-treated patients and fully accounted for the difference in cholesterol levels. Indeed, regardless of therapy, patients not receiving prednisone exhibited lower cholesterol levels than prednisone-treated patients and controls. We conclude that prednisone therapy, rather than CyA or tacrolimus immunosuppression, seems to be the major determinant of increased cholesterol levels.