肾移植患者个体化免疫诱导治疗方案的临床评价  

Individual immune induction therapy after kidney transplantation: A clinical evaluation

作　　者：王锁刚[1] 陈铸[1] 于江琪[1] 赵桂平[1] 崔勇[1] 何伟[1] 张翥[1] 王光策[1] 

机构地区：[1]河南中医学院第一附属医院肾移植科,郑州450000

出　　处：《肾脏病与透析肾移植杂志》2013年第3期219-223,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的:评价兔抗人T淋巴细胞免疫球蛋白(ATG-F)、巴利昔单抗(Basiliximab)在肾移植个体化免疫诱导治疗中的有效性及安全性,探讨肾移植免疫抑制诱导的个体化治疗方案。方法:回顾性分析381例肾移植受者的临床资料,其中应用ATG-F诱导179例,Basiliximab诱导124例,78例未接受免疫诱导者为对照组。所有肾移植受者术后均采用常规免疫抑制方案抗排斥治疗。对不同组受者术前的一般情况、术后肾功能恢复、移植人/肾存活率及早期并发症的发生情况等进行对比。结果:ATG-F组与Basiliximab组急性排斥反应、早期移植肾功能恢复、12月的移植人/肾存活率差异无统计学意义(P>0.05),均优于对照组(P<0.05);ATG-F组与Basiliximab组感染及相关并发症发生率稍高于对照组,但三组间比较无显著的统计学差异。结论:临床应用抗体诱导治疗是安全、有效的,但应严格遵守适应证和禁忌证的筛选原则,采取个体化的免疫诱导疗法,积极预防相关并发症,有利于减少排斥反应的发生,提高移植人/肾的存活率。Objective：To evaluate the efficacy and safety of rabbit anti-human T lymphocyte immune globulin （ATG-F ）and Basiliximab for individualized immune induction therapy in kidney transplantation, and to further discuss the individualized treatment regime in the immune induction of kidney transplantation. Methodology： Three hundred eighty one cases with kidney transplant, including rabbit anti-human T lymphocyte immune globulin （ATG-F）-Induced 179 cases, Basiliximab-Induced 124 cases and 78 cases without immune induction therapy as the control group were retrospective analyzed. All recipients after kidney transplantation were accepted conventional immunosuppressive regimens for anti-rejection therapy. General situation of different groups in patients with preoperative and postoperative graft function recovery, the survival rate of patient and kidney within one year and early complications were analyzed and compared. Results： There was no significant difference in the acute rejection incidence, early graft function recovery, the survival rate of patient and kidney within one year between ATG-F group and Basiliximab group（P〉0.05）, but which were better than that of control group（P〈0.05. The incidence of infection and associated-complications in ATG-F group and Basiliximab group were a little more than that of control group, but no significant difference was found in three groups（P〉0.05）. Conclusion： The clinical application of antibody induction therapy was safe and effective for recipients after kidney transplantation, but should strictly observe the principle of selection of indications and contraindications, taking individual induction therapy, preventing associated complications, which may effectively reduce the incidence of rejection and enhance the survival rate of patients and kidneys.

关 键 词：肾移植 抗体类生物制剂 免疫诱导 

分 类 号：R699[医药卫生—泌尿科学]