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目的:探讨CsA顺序用药对肾移植长期存活的影响。方法:随机选择32例肾移植患者术后立即应用OKT3,并以同期56例术后立即应用CsA的患者为对照。结果:OKT3组及CsA组急性排斥反应(AR)发生率分别为34.4%和64.3%(P<0.01),难治性排斥反应发生率OKT3组为9.1%,CsA组为30.6%(P<0.05)。术后首次AR发生时间,CsA组为13.1±1.3d,OKT3组为22.5±3.2d(P<0.001)。CsA组和OKT3组4年人存活率相似(分别为85.7%和90.6%),4年肾存活率CsA组为71.4%,OKT3组为87.5%(P<0.05)。结论:CsA顺序用药能显著减少AR及难治性排斥反应发生率,延迟排斥反应发生时间,提高肾移植长期存活率。
Objective: To investigate the effect of sequential administration of CsA on the long-term survival of renal allografts. Methods: OKT3 was applied immediately after operation in 32 renal transplant recipients and 56 patients were treated with CsA immediately after surgery. Results: The incidences of acute rejection (AR) in OKT3 group and CsA group were 34.4% and 64.3% respectively (P <0.01). The incidences of refractory rejection were 9.1% in OKT3 group and 30.6% in CsA group (P <0.05) ). The time of first AR onset was 13.1 ± 1.3 days in CsA group and 22.5 ± 3.2 days in OKT3 group (P <0.001). The 4-year survival rates of CsA group and OKT3 group were similar (85.7% and 90.6% respectively). The 4-year renal survival rate was 71.4% in CsA group and 87.5% in OKT3 group (P <0.05). Conclusion: Sequential CsA administration can significantly reduce the incidence of AR and refractory rejection, delay the time of rejection, and improve the long-term survival rate of renal transplantation.