短期应用单克隆抗体CD_3预防肾移植术后早期排斥反应  

SHORT-TERM APPLICATION OF MONOCLONAL ANTIBODY-CD_3 IN THE PREVENTION OF EARLY REJECTIONS FOR KIDNEY RECIPIENTS

作　　者：孙立江[1] 李延江[2] 毛欣[2] 董震[2] 阎靖中[2] 

机构地区：[1]西安交通大学第一医院,陕西省西安市710061 [2]青岛大学医学院附属医院泌尿外科

出　　处：《青岛大学医学院学报》2002年第1期46-48,共3页Acta Academiae Medicinae Qingdao Universitatis

摘　　要：①目的　探讨短期应用单克隆抗体CD3 (OKT3 )预防肾移植术后早期严重排斥反应的效果和安全性。②方法　对照组 35例肾移植病人术后常规应用甲基泼尼松龙、环磷酰胺、泼尼松、骁悉和环孢霉素A ;实验组33例在上述用药基础上 ,术后前 5d连续应用OKT3 5mg静脉注射。③结果　实验组除 1例肾小管坏死的病人因发生急性排斥反应、自发性移植肾破裂而切除肾脏 ,无其他严重并发症。对照组 2例发生加速排斥反应 ,应用OKT3 后 1例加速排斥反应逆转 ,1例死亡 ;4例发生急性排斥反应 ,应用OKT3 后全部逆转。两组排斥反应发生率比较差异有显著性 (χ2 =4 .72 5 ,P <0 .0 5 )。④结论　肾移植术后短期应用OKT3 能有效地预防早期严重排斥反应 。Objective\ To investigate the effect and reliability of using OKT 3 for a short period to prevent early post operative severe rejections in kidney recipients. \ Methods\ Methylprednisolone, Cyclophosphamide, Prednisolone, Mycophenolate Mofetil, and Cyclosporine A were routinely used in the Control Group (35 recipients). OKT 3 (5mg/d) was administered intravenously in the Experimental Group (33 recipients) for the first 5 days after operation , in addition to above drugs used in the Control Group. \ Results\ In the Experimental Group, an acute rejection occurred in 1 patient with acute tubule necrosis and the transplanted kidney was eventually removed because of spontaneous rupture. There were no other severe complications found in this group. In the Control Group, 2 accelerated rejections and 4 acute rejections occurred in 6 patients, one of them with accelerated rejection died and the others rehabilitated after administration of OKT 3. The difference was significant between the two groups ( χ 2 =4.725,P <0.05).\ Conclusion\ An application of OKT 3 for a short period after operation is effective and safe in the prevention of early severe rejections in kidney recipients.

关 键 词：肾脏移植 移植物抗宿主反应 免疫抑制 CD3抗体 

分 类 号：R699.2[医药卫生—泌尿科学] R392.4[医药卫生—外科学]