抗CD25抗体在致敏受者肾脏移植免疫诱导治疗中的临床观察  

Anti-CD25 Ab (Zenapax) induction therapy in sensitized recipients of renal transplantation

作　　者：明爱民[1] 林民专[1] 顾新伟[1] 赵明[1] 李民[1] 

机构地区：[1]第一军医大学珠江医院器官移植科,广州510280

出　　处：《中华器官移植杂志》2003年第4期242-243,共2页Chinese Journal of Organ Transplantation

摘　　要：目的　评价致敏受者肾脏移植应用抗CD2 5抗体 (赛尼哌 )作为免疫诱导治疗的有效性和安全性。方法　将 36例接受肾移植的致敏受者随机分为两组 ,赛尼哌组 18例 ,OKT3组 18例。所有患者免疫抑制维持治疗为他克莫司 (FK5 0 6 )或环孢素A(CsA) +霉酚酸酯 (MMF) +泼尼松(Pred)三联疗法。赛尼哌组 :分别在术前 2 4h和术后 14d静脉内输入 5 0mg赛尼哌 ;OKT3组 :术后第 1d开始应用OKT3,每天 5mg ,持续 5～ 10d。观察两组术后半年内急性排斥 (AR)、移植肾功能延迟恢复 (DGF)的发生情况。结果　有 7例患者术后发生AR ,其中赛尼哌组 4例 ,OKT3组 3例。有13例发生DGF ,其中赛尼哌组 4例 ,OKT3组 9例 (P <0 .0 1)。在过敏反应、细胞因子释放综合征、神经系统症状、感染等方面 ,赛尼哌组发生率明显低于OKT3组 (P <0 .0 5 )。结论　赛尼哌是一种强效安全的免疫抑制剂 ,在致敏受者肾移植的免疫诱导治疗中效果满意。Objective To explore the efficacy and safety of anti-CD25 Ab (Zenapax) induction therapy in sensitized recipients following renal transplantation. Methods Thirty-six sensitized recipients were retrospectively analyzed and divided into Zenapax group and OKT3 group. Main immunosuppressive therapy regimen consisted of steroids, acrolimus or cyclosporine and mycophenolate mofetil in all recipients. Zenapax group received 2-dose Zenapax (50?mg) intravenous infusion on day 0 and week 2. OKT3 group received OKT3 (5?mg, daily) intravenous infusion from postoperative day 1 to day 5 or 10. Results The demographics were not significantly different between Zenapax group and OKT3 group. During a follow-up of 6 months 4 cases were subjected to acute rejection (AR) in Zenapax group and 3 in OKT3 group ( P > 0.05 ). In Zenapax and OKT3 groups, 1 and 2 allografts were removed as a result of rupture respectively. 4 cases were suffered from delayed graft function(DGF) in Zenapax group and 9 in OKT3 group respectively with the difference being significant ( P < 0.01 ). The incidence of allergy cytokine release syndrome and infection in Zenapax group were significantly lower than in OKT3 group ( P < 0.05 ). Conclusion Zenapax is a safe and effective induction therapy in sensitized recipients and can substitute for OKT3 in renal transplantation.

关 键 词：肾脏移植 免疫诱导治疗 抗CD25抗体 赛尼哌 急性排斥反应 

分 类 号：R699.2[医药卫生—泌尿科学] R979.5[医药卫生—外科学]