阿伦和达珠单抗与抗胸腺蛋白对肾移植的有效性及安全性比较  

Efficacy and safety of alemtuzumab, daclizumab and antithymocyte globulin in kidney transplantation

作　　者：王涛[1] 郝文静[1] 宗焕涛[1] 张勇[1] 

机构地区：[1]首都医科大学附属北京天坛医院,北京市100050

出　　处：《中国组织工程研究》2015年第2期305-309,共5页Chinese Journal of Tissue Engineering Research

摘　　要：背景:免疫抑制剂是通过影响机体的体液免疫和细胞免疫抑制机体的免疫功能来完成抗急性排斥反应,提高人/肾存活率。目的:比较3种免疫抑制诱导剂阿伦单抗、达珠单抗和抗胸腺蛋白在肾移植免疫诱导中的有效性与安全性。方法:运用Cochrane系统评价法,检索1966年至2011年PUBMED,EMBASE等数据库。纳入阿伦单抗、达珠单抗和抗胸腺蛋白3种药物在肾移植中的随机对照试验(RCT)进行Meta分析。结果与结论:9个RCT的777例患者纳入分析,3种药物24个月的人/肾存活率和急性排斥发生率差异无显著性意义(均P>0.05)。随访36个月时,阿伦单抗感染率显著低于抗胸腺蛋白(P<0.05)。分析结果表明,3种药物的免疫诱导效果相近;随访36个月时,阿伦单抗较抗胸腺蛋白的感染率低。BACKGROUND：Immunosuppressants fight against acute rejections by influencing humoral and celular immune to suppress the immune function, and then improve patient/renal graft survival. OBJECTIVE：To evaluate the effectiveness and safety of alemtuzumab, daclizumab and antithymocyte globulin in inducing immunosuppression in kidney transplantation. METHODS：The randomized controled trials of alemtuzumab or daclizumabversusATG in kidney tranplantation published from 1966 to 2011 were enroled by searching PubMed and EMBASE using Cochrane systematic review. We colected data and major outcomes. And a meta-analysis was conducted on homogeneous studies. RESULTS AND CONCLUSION： A total of 9 randomized controled trials （777 patients） about kidney transplantation were included. The meta-analysis results showed that the safety items including patient/renal graft survival and acute rejection at a folow-up of 24 months had no statistical differences among the three drugs （al P 〉 0.05）. But there was a significant difference between the infection rates of alemtuzumab and antithymocyte globulin at 36 months of folow-up （P 〈 0.05）. The results indicate that alemtuzumab, daclizumab and antithymocyte globulin are equaly effective in inducing immunosuppression at a folow-up of 24 months in kidney transplantation. However, compared to antithymocyte globulin, alemtuzumab has a lower rate of infection at a folow-up of 36 months.

关 键 词：组织构建 组织工程 阿伦单抗 达珠单抗 肾移植 器官移植 抗胸腺蛋白 META分析 

分 类 号：R318[医药卫生—生物医学工程]