骨髓输注和抗淋巴细胞球蛋白诱导对同种异体移植肾特异性免疫无反应性的临床研究  

Specific unresponsiveness to renal allografts induced by bone marrow transplantation and ALG

作　　者：何小舟[1] 巢志复[1] 车文骏[1] 经浩[1] 徐仁芳[1] 丁鸿[1] 王建平[1] 解斯杰[1] 薛忠[1] 吴强[1] 蒋国新 徐力 

机构地区：[1]常州市第一人民医院泌尿外科,常州市中心血站

出　　处：《中华泌尿外科杂志》1996年第7期405-408,共4页Chinese Journal of Urology

摘　　要：国外使用抗淋巴细胞球蛋白（ＡＬＧ）和输入供体特有骨髓（ＢＭ）诱导同种移植物的耐受力，并建立了动物模型。我们将这研究用于诱导特异性免疫无反应性病例２０例（骨髓组），并随机抽样２２例尸体肾移植患者作为对照组。骨髓组接受常规三联免疫抑制治疗，在１４天从ＡＬＧ诱导期后，停用１周，于第７天输入冷藏骨髓，随访５～４１个月。结果：１～６个月发生排斥反应２例（２／２０），均用大剂量激素逆转；另１例合并败血性肺炎死亡。对照组采用三联常规免疫抑制治疗剂量较骨髓组大，但不输入骨髓，结果同期发生排斥反应６例（６／２２），后期排斥反应２例，其中４例因排斥反应未能逆转而移植肾失功，有１例因合并心衰死亡。从两组结果分析，人的一年成活率两组无明显差别。移植肾一年成活率则骨髓组高于对照组（Ｐ＜０．０１），排斥反应发生率骨髓组明显低于对照组（Ｐ＜０．０５），且骨髓组常规免疫抑制剂用量较对照组小。Bone marrow transplantation from the donor and ALG therapy were carried out for 20 patients with cadaveric renal allograft. Another 22 patients with cadaveric renal allograft served as controls. The patiens have been followed up for 5～41 months. In the bone marrow group,rejection occured in 2(2/20) within 1～6 months and both have been successfully reversed on appropriate immunosupressive therapy.Another patients died of septicemic pneumonia, Whereas in the control group,rejection occured in 6(6l22),in 4 of them reverse of the rejection being failed with loss of the allograft function;1 patient died of heart failure, There was no remarkable difference in 1-year patient survival rate, while the 1-year graft survival rate being much higher with the bone marrow group(P< 0.01).The doses of conventional immunosupressives required were lower in the bone marrow group.

关 键 词：肾移植 免疫耐受 抗淋巴细胞 球蛋白 骨髓 

分 类 号：R699.203[医药卫生—泌尿科学] R392.4[医药卫生—外科学]