肾移植受者预防性应用兔抗人胸腺细胞免疫球蛋白的有效性和安全性  

The efficacy and safety for prophylactic application of rabbit anti-thymocyte globulin in renal transplantation

作　　者：王科[1] 高振利[1] 柳东夫[1] 王琳[1] 杨典东[1] 孙德康[1] 万峰春[1] 王建明[1] 宋德花[1] 

机构地区：[1]青岛大学医学院附属烟台毓璜顶医院泌尿外科,山东烟台264000

出　　处：《中华器官移植杂志》2009年第9期556-558,共3页Chinese Journal of Organ Transplantation

摘　　要：目的探讨肾移植受者预防性应用兔抗人胸腺细胞免疫球蛋白（ATG-R）的有效性和安全性。方法选择2003年5月至2006年12月期间的肾移植受者655例，分为试验组（84例）和对照组（571例）。两组受者在年龄、性别、群体反应抗体（PRA）、HLA配型、常规免疫抑制剂的应用等方面比较，差异无统计学意义。对试验组受者采取术前1次较大剂量（1．5mg／kg）和术后短时间小剂量（0．5～1mg／kg）预防性应用ATG-R；对照组受者仅采用常规免疫抑制方案。分析和比较两组受者术后移植物功能延迟恢复（DGF）发生率、术后6个月内急性排斥反应（AR）发生率、术后6个月内感染发生率及人／。肾1年存活率等指标。结果试验组和对照组DGF发生率分别为2．38％和8．40％，试验组明显低于对照组，差异有统计学意义（P〈0.01）；术后6个月内AR发生率分别为4．76％和11．03％，试验组低于对照组，差异有统计学意义（P〈0．05）；试验组和对照组术后6个月内感染发生率分别为10．71％和9．81％，两组比较，差异无统计学意义（P〉0．05）。两组的人／肾1年存活率比较，差异也无统计学意义（P〉0．05）。结论肾移植受者预防性应用ATG-R能够明显降低DGF和AR发生率，且不增加感染发生率，是一种有效和安全的免疫诱导措施。Objective To study the efficacy and safety of prophylactic application of rabbit antithymocyte globulin （ATG-R） in renal transplantation. Methods Between May 2003 and December 2006,655 cases of kidney recipients were selected at our hospital, and divided into experiment group （n = 84） and control group （n = 571） according to the prophylactic application of ATG-R. There was no apparent difference in age, sex, PRA, HLA match and other immunosuppression administration between two groups. For experiment group, single bolus high dose （1.5 mg/kg） before operation and short-time lower dose （0. 5-1 mg/kg） ATG-R after transplantation ATG-R were given as prophylactic application. DGF and 6-month AR rate, 6-month infection rate, one-year graft and recipient survival rate were compared. Results In experiment and control groups, DGF rate was 2. 38 % and 8. 40 respectively,P〈0. 01 ; 6-month AR rate was 4. 76 % and 11.03 % respectively, P〈0. 05. 6-month infection rate was 10. 71 % and 9. 81 % respectively, P〉0. 05. There was no difference in one-year graft and recipient survival rate between two groups,P〉0. 05. Conclusion For kidney recipients, the prophylactic application of ATG-R could reduce DGF and AR rate significantly, but not increase infection rate,suggesting it is an effective and safe immunity induction method.

关 键 词：肾移植 兔抗人胸腺细胞免疫球蛋白 预防 

分 类 号：R686[医药卫生—骨科学]