抗CD25单抗联合血浆分离在高敏肾移植受体应用的临床研究  

Treatment with anti-CD25 monoclonal antibody and filtration plasmapheresis in highly sensitive kidney recipients

作　　者：陈江华[1] 彭文翰[1] 吴建永[1] 吴东波[1] 王逸民[1] 

机构地区：[1]浙江大学医学院附属第一医院肾脏病中心,杭州310003

出　　处：《中华肾脏病杂志》2003年第5期274-277,共4页Chinese Journal of Nephrology

摘　　要：目的 探讨抗CD25单抗联合血浆分离在群体反应性抗体(PRA)阳性的高敏肾移植受体中的应用价值。方法 在41例PRA平均为52.2％的高敏肾移植受体中,24例仅用双滤过法血浆分离(DFPP)预处理(对照组),17例在DFPP处理的基础上加用两个剂量的抗CD25单抗诱导治疗(治疗组),比较两组急性排斥反应的发生率、严重程度和逆转情况、1年人/肾存活率以及并发症的发生。结果 治疗组仅2例(11.8％)发生急排,分别为ⅠA和ⅡB级,对照组1例(4.2％)发生超排,10例(41.7％)发生急排,ⅡA级以上有6例,2组差异有显著性意义(P=0.039)。一年人/肾存活率治疗组为100％/94.1％,对照组为100％/91.7％,两组并发症无明显差异。结论 PRA阳性的高敏肾移植受体在DFPP基础上应用抗CD25单抗能显著降低急性排斥的发生,减轻排斥反应的严重程度,获得满意的1年人/肾存活率。Objective To investigate the treatment with anti-CD25 monoclonal antibody on the basis of double filtration plasmapheresis (DFPP) in highly sensitive kidney recipients. Methods In 41 highly sensitive recipients [panel reactive antibody (PRA) 52. 2% in average),24 cases were only treated with DFPP before operations (control group) and 17 cases were treated with anti-CD25 monoclonal antibody on the basis of DFPP (treatment group). Incidence and severity of acute rejection,1-year survival rate of human/ kidney and complications were made a comparison between the two groups. Results In treatment group,2 cases (11. 8% ) were suffered from acute rejection (type IA and IIB respectively) and in control group,1 case (4. 2% ) was suffered from hyperacute rejection and 10 cases (41.7% ) were suffered from acute rejection (6 cases beyond type IIA),Which was significantly different between the two groups ( P = 0. 039). One year survival rate of human/kidney was 100% /94. 1% in treatment group and 100%/91.7% in control group. Incidence of complications was not significantly different between the two groups. Conclusions Treatment with anti-CD25 monoclonal antibody on the basis of DFPP can significantly decrease incidence and severity of acute rejection in highly sensitive kidney recipients and possess satisfactory 1-year survival rate of human/kidney.

关 键 词：抗CD25单抗 血浆分离 高敏肾移植受体 应用 临床研究 

分 类 号：R699[医药卫生—泌尿科学]