巴昔利单抗与抗胸腺细胞球蛋白在肾移植早期效果的比较  

Comparison of basilimab and antithymocyte globulin for clinical efficacy in early stage post renal transplantation

作　　者：顾梅[1] 张昆鹏[1] 关炳星[1] 党受涛[1] 龙志华[1] 朱长雨[1] 

机构地区：[1]首都医科大学附属北京同仁医院移植中心,北京100730

出　　处：《中国医院药学杂志》2009年第8期659-662,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的：比较分析巴昔利单抗和抗胸腺细胞球蛋白（ATG）2种抗排斥药物在同种异体肾移植早期临床使用的效果。方法：将59例肾移植患者分为2组，ATG组42例使用ATG免疫诱导治疗，巴昔利单抗组17例使用巴昔利单抗免疫诱导治疗。从肾移植术后急性排斥反应发生率、血肌酐恢复正常时间、1～4周血肌酐及尿素氮水平、感染发生率、术后前3d尿量及术后住院时间、住院费用等多方面观察分析两种药物在肾移植术后早期临床应用的效果。结果：巴昔利单抗组患者较ATG组患者急性排斥反应发生率低、血肌酐恢复正常快、1～4周血肌酐及尿素氮水平低、感染发生率低、住院时阃短。结论：IL－2可能在肾移植术后排斥反应中发挥更加重要的作用；使用巴昔利单抗可以更好的预防肾移植术后急性排斥反应的发生。OBJECTIVE To compare and analyze clinical efficacy of tow-dose basiliximab and three-dose antithymocyte globulin （ATG） in cadaverie renal transplantation recipients. METHODS 59 renal transplant recipients were divided into 2 groups： ATG group （n = 42） and basiliximab group （n = 17）. ATG group received three-dose ATG （100 mg intravenous infusion） on day 0, 1, 2 after renal transplantation. Basiliximab group received two-dose basiliximab （20 mg intravenous infusion） 2 hours before operation and 4 days after transplantation. The two groups were compared for acute rejection ratio, time of sCr to became normal, graft function （sCr, BUN） following transplantation （1 week, 2 weeks,3 weeks,4 weeks after transplantation）, infection ratio, urine volume, hospitalization time and total cost. RESULTS The number of acute rejection episodes were 1 in basiliximab group （5.9%） and 12 in ATG group （28. 6%） （P≤0. 05）. The time of sCr to became normal in basiliximab group is shorter than ATG group （7. 4 vs 13. 5 days）. Graft function of basiliximab group is better than ATG group. Patients in basiliximab group have a lower infection incidence and a shorter hospitalization time than ATG group. CONCLUSION Interlukin- 2 may play a more important role in acute rejection of renal transplantation; Two doses of basiliximab can effectively decreased the incidence of acute rejection in renal allograft recipients.

关 键 词：肾移植 巴昔利单抗 抗胸腺细胞球蛋白 预防排斥 

分 类 号：R65[医药卫生—外科学]