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目的 评估达利珠单抗 (抗CD2 5单克隆抗体 )诱导治疗后的抗排斥反应疗效。方法 对 1 999年 9月～ 2 0 0 4年 4月间使用达利珠单抗的 6 2例患者进行随访和统计。所有患者均在术中血管开放前 1h应用达利珠单抗 5 0mg ,术后常规应用激素、环孢素A和霉酚酸酯。根据达利珠单抗的用量分为 1剂组、2剂组和大于 2剂组。结果 随访时间最长达 4年 9个月 ,最短 3个月。随访期间共发生急性排斥 7例 (1 1 .3%) ,最早 1例发生在术后 2个月 ,最晚为术后 1 4个月 ,平均 1 0 .3个月 ;4例经过激素冲击治疗 ,完全逆转 ,2例部分逆转 ,仅 1例发生于术后 1 0个月的排斥 ,激素冲击治疗无效 ,术后第 1 3个月移植肾失功而切除。结论 应用达利珠单抗诱导治疗 ,肾移植术后急性排斥发生率降低 ,并使急性排斥发生时间推迟 ,程度减轻 ;可以安全、有效的减少环孢素的剂量。
Objective To evaluate the anti-rejection effect of dalizumab (anti-CD25 monoclonal antibody) induction therapy. Methods Sixty-two patients with daclizumab between September 1999 and April 2004 were followed up and statistically analyzed. All patients were treated with daltezumab 50 mg 1 h prior to intraoperative vascular opening, and hormones, ciclosporin A and mycophenolate mofetil were routinely applied after surgery. According to the dosage of daclizumab is divided into 1 dose group, 2 dose group and more than 2 dose group. Results The follow-up time was up to 4 years and 9 months, the shortest 3 months. Acute rejection occurred in 7 cases (11.3%) during the follow-up period. The earliest occurred in 2 months after operation and the latest after 14 months (average, 10.3 months). In 4 cases, Treatment, complete reversal, partial reversal in 2 cases, only 1 case of rejection occurred in 10 months after surgery, hormone therapy was ineffective, the first 13 months after transplantation, renal failure and excision. Conclusion The induction of daclizumab treatment reduces the incidence of acute rejection after renal transplantation and delays the acute rejection for a certain period of time. It is safe and effective to reduce the dose of cyclosporine.