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【目的】比较在亲体肾移植中,采用提前口服免疫抑制剂方案或术前抗CD25诱导方案对于受体术后早期安全性和有效性的影响。【方法】60例亲体肾移植受体均采用钙调蛋白阻滞剂(CNI)+吗替麦考酚酯(MMF)+激素(Prednisone)三联免疫治疗,按是否应用抗CD25诱导随机将其分为两组,诱导组(Ⅰ组)30例,提前口服免疫抑制剂组(以下简称提前用药组,Ⅱ组)30例,观察比较两组在术后3个月内安全性和有效性的情况,以及两组部分病例移植1年后人/肾存活率和肌酐清除率(Ccr)的情况。【结果】诱导组2例(6.7%)和提前用药组1例(3.3%)发生急性排斥反应(P=1.00);两组术后3个月内的血清肌酐(Scr)及肾功能恢复情况,肝功能损害、白细胞减少、感染等并发症情况以及部分移植一年后患者人/肾存活率和肌酐清除率情况,均无统计学意义(P>0.05)。【结论】在亲体肾移植中,提前口服用药方案的使用是安全、有效的,可以替代抗CD25诱导方案,其远期效果及适用范围有待于进一步观察。
【Objective】 To compare the effect of early oral immunosuppressant or preoperative anti-CD25 induction on the safety and efficacy of early postoperative recipients in parental kidney transplantation. 【Methods】 60 cases of donor kidney transplant recipients were treated with CNI + MMF + Prednisone triple immunotherapy. According to whether they were induced by anti-CD25 or not, Thirty patients in induction group (group Ⅰ) and 30 patients in early oral immunosuppressant group (hereinafter referred to as preemptive medication group and Ⅱ group) were observed and compared for safety and efficacy within 3 months after operation , And the survival rate of human / kidney and creatinine clearance (Ccr) after one year in two groups of patients. 【Results】 The acute rejection reaction occurred in 2 cases (6.7%) in induction group and 1 case (3.3%) in early treatment group (P = 1.00). Serum creatinine (Scr) and renal function recovery , Liver damage, leukopenia, infection and other complications as well as one year after the partial transplantation of patients with / survival rate of renal and creatinine clearance, no statistically significant (P> 0.05). 【Conclusion】 In parental kidney transplantation, the use of oral medication regimen in advance is safe and effective, which can replace anti-CD25 induction regimen. The long-term effect and applicability of this regimen need to be further observed.