抗淋巴细胞制剂诱导治疗对肾移植后人、肾长期存活的影响  

Impact of induction therapy with anti-lymphocyte agents on long-term survival of kidney transplantation

作　　者：徐健[1] 于立新[1] 杜传福[1] 邓文锋[1] 付绍杰[1] 王亦斌[1] 苗芸[1] 叶俊生[1] 余玉明[1] 

机构地区：[1]南方医科大学南方医院器官移植科,广州510515

出　　处：《中华器官移植杂志》2011年第6期355-357,共3页Chinese Journal of Organ Transplantation

摘　　要：目的探讨抗淋巴细胞制剂诱导治疗对肾移植后人、肾长期存活的影响。方法271例首次接受尸体肾移植的受者，其中使用抗胸腺细胞球蛋白诱导治疗者110例（ATG组），使用巴利昔单抗诱导治疗者88例（Bax组），未接受诱导治疗者73例（对照组）。所有受者术后采用他克莫司＋吗替麦考酚酯＋皮质激素的三联免疫抑制方案，并应用更昔洛韦预防CMV感染。术后对所有受者进行了1～5年的随访，观察和比较各组术后6个月内的并发症发生情况，以及术后l、3、5年的人、肾存活率。结果ATG组、Bax组和对照组术后6个月AR的发生率分别为9．1％（10／110）、10．2％（9／88）和17．8％（13／73），ATG组和Bax组间AR发生率的差异无统计学意义（P〉0．05），但均显著低于对照组（P〈0．05）。3组间移植肾功能恢复延迟、CMV感染及非CMV感染等发生率的比较，差异均无统计学意义（P〉0．05）。ATG组和Bax组术后1、3、5年移植肾存活率分别为95．5％、90．9％、87．3％和93．2％、87．5％、83．8％，均显著高于对照组的87．7％、80．8％、75．3％（P〈O．05）。结论应用抗淋巴细胞制剂进行免疫诱导治疗可显著降低肾移植术后早期AIR的发生率，并显著改善移植肾的长期存活率。Objective To explore the impact of induction therapy with anti-lymphocyte agents on long-term survival of kidney transplantation. Methods 271 recipients of first cadaveric kidney transplants were treated with tacrolimus, rnycophenolate mofetil and prednisone. 110 patients of them received induction therapy with anti-thymocyte globulin （ATG group）, 88 patients received Basiliximab （Bax group）, and the remaining 73 patients did not receive induction therapy （control group）. The data of AR, DGF, CMV infection, and 1- 3- 5-year patient/allograft survival rate in three groups were retrospectively during a follow-up period of 1 to 5 years postoperatively. Results Within 6 months after operation, the incidence of AR in control group, ATG group and Bax group was 17. 8% （13/73）, 9. 1% （10/110） and 10. 2 % （9/88） respectively. The incidence of AR in ATG group and Bax group was significantly lower than in control group （P〈0. 05）. There was no significant difference in incidence of DGF and CMV infection among three groups. The 1-, 3- and 5-year allograft survival rate postoperation in ATG group and Bax group was 95. 5 %, 90. 9 % ,87. 3 % and 93. 2%, 87. 5%, 83. 8 % respectively, which was significantly higher than in control group （87. 7 %, 80. 8%and 75. 3 %, P〈0. 05）. Conclusion Induction therapy with anti-lymphocyte agents may reduce the early incidence of AR and prolong long-term allograft survival significantly.

关 键 词：肾移植 诱导治疗 抗胸腺细胞球蛋白 巴利昔单抗 

分 类 号：R699.2[医药卫生—泌尿科学]