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：
10.1111/j.1432-2277.1998.tb00789.x
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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
肝移植术后血脂异常很常见，但其潜在机制尚不清楚。我们研究了27例肝移植受者的血脂谱，随机接受环孢菌素（CpA，n = 14）或他克莫司（n = 13），并将其与20例健康对照组进行比较。移植前，患者的总胆固醇和低密度脂蛋白（LDL）胆固醇较低（与对照组相比），并在短期内增加，即，移植后3个月。移植后18个月，总胆固醇和低密度脂蛋白胆固醇水平下降到移植前的值，但往往保持较高的CyA治疗的患者。然而，当时，泼尼松治疗在CyA治疗的患者中比他克莫司治疗的患者更普遍，并充分解释了胆固醇水平的差异。事实上，无论治疗，未接受泼尼松的患者表现出低于泼尼松治疗的患者和对照组的胆固醇水平。我们的结论是泼尼松治疗，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.