Prospective study of methylprednisolone and prednisone therapy for patients with pulmonary infection after renal transplantation
10.3969/j.issn.1006-5725.2017.01.006
- VernacularTitle:甲泼尼龙与醋酸泼尼松治疗肾移植术后肺部感染
- Author:
Zhenpu WANG
;
Xin JIANG
;
Shuzhai MIAO
;
Qingshan QU
- Keywords:
Methylprednisolone;
Prednisone;
kidney transplantation;
Severe pneumonia
- From:
The Journal of Practical Medicine
2017;33(1):22-26
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical efficacy of methylprednisolone intravenous infusion and to take oral prednisone for patients with pulmonary infection after renal transplantation. Methods One hundred and thirty?six patients with severe pulmonary infection after renal transplantation in our hospital from January 2013 to January 2016 were enrolled and randomly divided into 2 groups. All patients were treated with immunosuppressant adjustment based on the basis of routine treatment. Patients in the observation group were applied methylprednisolone, while patients in the control group were applied prednisone. The clinical efficacy between 2 groups were compared. The changes of body temperature, PaO2 during treatment in survivors of both 2 groups and the changes of ACR, Scr, urine β2?macroglobulin after treatment in survivors of both groups were compared. Results There were 2 cases died and 1 case of renal allograft dysfunction in the observation group. There were 2 cases died and 3 case of renal allograft dysfunction in the observation group. No significant difference in clinical efficacy was found between 2 groups (P > 0.05). For survivors, the recovery time of body temperature in the observation group was significantly shorter than that in the control group. From 16 hours until 4 days after treatment, the body temperature in the observation group was significantly lower than that in the control group (P<0.05), the recovery time of PaO2 in the observation group was significantly shorter than that in the control group. From 2 days until the end of statistics after treatment, PaO2 in the observation group was significantly lower than that in the control group (P<0.05). ACR, Scr, urine β2?macroglobulin were significantly increased in all survivors (P < 0.05). There were no significant differences between 2 groups at every time point (P > 0.05). Conclusion Methylprednisolone can decrease body temperature and increase PaO2 in patients with pulmonary infection after renal transplantation rapidly, with no effects on reducing the mortality and renal allograft dysfunction, and the middle?time renal function.