论文部分内容阅读
目的 :探讨达利珠单抗在预防同种肾异体移植术后急性排斥反应的作用。方法 :回顾分析了已随访 1a的 2 8例 (男性 2 4例 ,女性 4例 ,年龄 32a±s 5a)应用 2剂达利珠单抗的病人的临床效果 ,并以同期肾移植 80例 (男性 6 8例 ,女性 12例 ,年龄34a± 11a)作为对照组。所有病人均给予以麦考酚酸酯 (mycophenolatemofetil,MMF) ,环孢素 (ci closporin ,CsA) ,甲基强的松龙 (methylprednisolone ,MPD)和泼尼松 (prednisone ,Pred)为基础的免疫抑制方案 ;达利珠单抗在基础治疗方案上 ,分别于手术前 2 4h内和手术后d 14按照剂量为 1mg·kg- 1通过静脉注射给药。观察急性排斥反应发生率、药物不良反应、感染发生率、病人和移植物的 1a存活率。所有病人均随访 1a以上。结果 :达利珠单抗组在 3mo内急性排斥反应发生率 (4% )显著低于对照组 (2 5 % ) ,差异有显著意义 (P <0 .0 5 ) ;达利珠单抗具有良好的耐受性 ,无细胞因子释放综合征的发生 ;在感染及不良反应方面与对照组比较无显著性差异 ;2组比较病人 1a的存活率 (达利珠单抗组为 89% ,对照组为 96 % )和移植肾存活率 (达利珠单抗组 89% ,对照组 94 % )无显著性差异 (P >0 .0 5 )。结论 :2剂达利珠单抗加上MMF ,CsA ,MPD ,Pred联合应用的免疫抑制方案对预防同种异
Objective: To investigate the effect of daclizumab in preventing acute rejection after allogeneic kidney transplantation. Methods: The clinical results of 28 patients (24 males, 4 females, 32a ± s 5a) who were treated with 2 doses of daclizumab were retrospectively analyzed. Eighty renal transplant recipients 68 males, 12 females, age 34a ± 11a) as a control group. All patients were immunized on the basis of mycophenolatemofetil (MMF), ci closporin (CsA), methylprednisolone (MPD) and prednisone (Pred) Dalizumab on the basis of treatment programs, respectively, within 24 hours before surgery and after surgery d 14 at a dose of 1mg · kg-1 administered by intravenous injection. The incidence of acute rejection, adverse drug reactions, incidence of infection, survival rate of 1a patients and grafts were observed. All patients were followed for more than 1a. Results: The incidence of acute rejection (4%) in daclizumab group was significantly lower than that in control group (2.5%) in 3 d (P <0.05), and daclizumab Good tolerability and no cytokine release syndrome. There was no significant difference in infection and adverse reactions between the two groups compared with the control group. Survival rate of la in group 2 (89% vs dalizumab group, control group Group 96%) and graft survival (89% of the daclizumab group, 94% of the control group) was no significant difference (P> 0.05). Conclusion: The combination of two doses of daclizumab plus MMF, CsA, MPD and Pred combined with immunosuppressive regimen in the prevention of allogeneic