OKT3治疗尸肾移植难治性排斥反应15例体会  

Clinical experience of treatment of 15 cases of refractory renal allograft rejection by OKT3.

作　　者：夏伟[1] 曾甫清[1] 李恒[1] 张润清[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院泌尿外科,武汉430022

出　　处：《华中医学杂志》2004年第6期389-390,共2页Central China Medical Journal

摘　　要：目的　了解抗CD3单克隆抗体 (OKT3)对肾移植难治性排斥反应的治疗效果和副作用。方法　采用回顾性分析 ,对 15例肾移植术后难治性排斥反应 (其中加速排斥反应 1例 ,急性排斥反应 14例 )应用OKT3治疗。结果　 1例加速排斥反应及 14例急性排斥反应逆转 ,总逆转率为 10 0 %。应用OKT3后出现副作用 :发热 5例 ,寒战 2例 ,呼吸困难 2例 ,头痛 4例 ,腹泻 5例 ,白细胞下降 3例。肺部感染 5例 ,其中巨细胞病毒感染 2例。结论　难治性排斥反应使用OKT3治疗效果显著。细胞因子释放综合征是OKT3治疗的主要副作用 。Objective To understand the curative effect and side effect of monoclonal antibody of anti CD3 (OKT3) in the treatment of refractory renal allograft rejection.Methods The OKT3 treatment of 15 cases of refractory renal allograft rejection (including one case of accelerated rejection and 14 cases of acute rejection) was studied retrospectively.Results One accelerated rejection and 14 acute rejection episodes were reversed. The reverse rate was 100%. Side effects of OKT3 were as follows: 5 cases of fever, 2 cases of chill, 2 cases of dyspnea, 4 cases of headache, 5 cases of diarrhea, 3 cases of leukocyte decrease, 5 cases of pulmonary infection (including 2 cases of cytomegalovirus infection). Conclusion OKT3 could effectively treat refractory renal allograft rejection.Cytokines release syndrome was the main side effects of treatment with OKT3 and cytomegalovirus infection was a very serious side effect of treatment with OKT3.

关 键 词：OKT3 治疗 排斥反应 难治性 副作用 尸肾移植 逆转 释放 

分 类 号：R699.2[医药卫生—泌尿科学] R473.6[医药卫生—外科学]