生物免疫诱导治疗对肾移植患者机体免疫状态的影响  

Immunologic induction therapy affects immune status of recipients after kidney transplantation

作　　者：李健[1] 许亚宏[1] 郭瑜[1] 马小平[1] 卢奕[1] 李阳波[1] 贾志刚[1] 赵启华[1] 罗顺文[1] 陈萍[1] 

机构地区：[1]解放军第四五二医院泌尿外科暨成都军区泌尿外科中心,四川省成都市610021

出　　处：《中国组织工程研究》2014年第36期5776-5780,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前生物制剂参与的免疫诱导治疗逐渐成为肾移植免疫抑制治疗方案的重要组成部分,既能有效预防急性排斥反应的发生,又能避免并发症的发生。目的:探讨不同生物制剂在肾移植免疫诱导治疗中对机体免疫状态及移植肾功能状态的影响。方法:回顾分析110例肾移植受者临床资料,根据应用生物免疫诱导治疗情况分组,单克隆抗体组(n=35)肾移植受者接受巴昔利单克隆抗体治疗,多克隆抗体组(n=43)肾移植受者接受兔抗人胸腺细胞免疫球蛋白治疗,对照组(n=32)肾移植受者未接受生物制剂免疫诱导治疗。对比分析3组受者在肾移植后1,4,12周的淋巴细胞绝对值、外周血CD4+T淋巴细胞亚群数量,并评价移植后12周内移植肾功能状态和感染并发症发生情况。结果与结论:单克隆抗体组、多克隆抗体组急性排斥反应发生率低于对照组(P<0.05),多克隆抗体组感染并发症发生率高于单克隆抗体组、对照组(P<0.05)。单克隆抗体组、多克隆抗体组移植后1,4,12周淋巴细胞绝对值均低于对照组(P<0.05)。多克隆抗体组移植后1,4,12周外周血CD4+T淋巴细胞亚群数量低于单克隆抗体组、对照组(P<0.05)。表明生物制剂参与的肾移植免疫诱导治疗方案可有效抑制移植受者活化T淋巴细胞功能状态,降低移植肾早期急性排斥反应的发生,但应用兔抗人胸腺细胞免疫球蛋白的感染并发症发生率较高。BACKGROUND：At present, biological agent-involved immunologic induction therapy gradual y became a key component in immunosuppression therapy of kidney transplantation. It can effectively prevent acute rejection and avoid the appearance of complications. OBJECTIVE：To evaluate the effect of different biological agents on immune state and functional status of transplanted kidney in immunologic induction therapy. METHODS：Clinical data of 110 recipients with kidney transplantation were retrospectively analyzed. In accordance with the conditions of immunologic induction therapy, recipients in the monoclonal antibody group （n=35） received basiliximab. Recipients in the polyclonal antibody group （n=43） underwent rabbit anti-human antithymocyteglobulin. Recipients in the control group （n=32） did not receive immunologic induction therapy. Absolute value of lymphocytes and the number of CD4＋T lymphocyte subsets in peripheral blood were comparatively analyzed among three groups at 1, 4 and 12 weeks after kidney transplantation. Functional status of the transplanted kidney and complications of infection were evaluated at 12 weeks after transplantation.RESULTS AND CONCLUSION：The incidence of acute rejection was lower in the monoclonal antibody group and polyclonal antibody group than in the control group （P〈0.05）. The incidence of infectious complications was higher in the polyclonal antibody group than in the monoclonal antibody group and control group （P〈0.05）. The absolute value of lymphocytes was lower in the monoclonal antibody group and polyclonal antibody group at 1, 4 and 12 weeks after transplantation than in the control group （P〈0.05）. The number of CD4＋T lymphocyte subsets in peripheral blood was lower in the polyclonal antibody group than in the monoclonal antibody group and control group at 1, 4 and 12 weeks after transplantation （P〈0.05）. These results suggested that biological agents participate in immunologic induction therapy of kidney transplantation, can effect

关 键 词：移植 组织构建 肾移植 植修复重建 单克隆抗体 多克隆抗体 免疫诱导 

分 类 号：R318[医药卫生—生物医学工程]