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目的:通过观察雷公藤防治尸体肾移植术后急性排斥反应的作用,验证雷公藤免疫抑制在抗排斥反应中的疗效。方法:39例肾移植患者接受雷公藤治疗,根据服用雷公藤剂量的不同分为双倍剂量组(n=20,2mg/kgd-1)和常规剂量组(n=19,1mg/kgd-1)。以同期未接受雷公藤治疗的肾移植患者作为对照(n=40)。所有患者均无合并感染、环孢素肾中毒和手术并发症的情况。三组之间的性别、年龄、冷热缺血时间、淋巴细胞毒性试验、群体反应性抗体水平都非常接近。结果:双倍剂量组患者术后1个月和3个月内无一例急排的发生,其对照组急排发生率分别高达25%~45%。常规剂量组术后1个月和3个月内仅各有1例急排的发生。同期对照组急排发生率为15%~35%。术后满3年的雷公藤常规剂量组,3年移植肾存活率为89.5%,显著高于其对照组移植肾65.0%的3年存活率。此外,长期服用雷公藤未有严重感染等并发症的增加。结论:雷公藤的确具有减少肾移植术后发生急性排斥反应的作用,有助于提高移植肾的长期存活率。
Objective: To observe the effect of Tripterygium wilfordii against acute rejection after cadaveric kidney transplantation to verify the efficacy of tripterygium wilfordii immunosuppression in anti-rejection. Methods: Thirty-nine patients undergoing renal transplantation were treated with tripterygium wilfordii, and were divided into double dose group (n = 20,2mg / kgd-1) and conventional dose group ). Patients who did not receive tripterygium on the same period were included as controls (n = 40). All patients had no coinfection, cyclosporine nephrotoxicity and complications of surgery. The three groups of gender, age, cold ischemia time, lymphocyte toxicity test, antibody levels of the population are very close. Results: In the double dose group, there was no case of acute discharge in one month and three months after operation. The incidence of acute discharge in the control group was as high as 25% -45%. Conventional dose group, one month after operation and three months after operation, only one case had emergency discharge. The same period the control group emergency discharge rate was 15% to 35%. After 3 years of operation, the conventional triptolide group had a 3-year graft survival rate of 89.5%, which was significantly higher than the 65.0% 3-year survival rate of the control group. In addition, long-term use of triptolide without serious complications such as increased infection. CONCLUSION: Tripterygium wilfordii indeed has the effect of reducing acute rejection after renal transplantation, and helps to improve the long-term survival of renal allografts.