论文部分内容阅读
目的:探讨肾移植术后尿液中IP-10在ATG治疗急性细胞性排斥反应时剂量及疗程评估方面的应用价值。方法:收集肾移植术后病理确诊为急性细胞性排斥反应的患者40例,随机将其分为IP-10组(n=20)和Scr组(n=20),测定此时两组患者尿IP-10和Scr水平,之后给予ATG治疗,并分别将IP-10和Scr水平变化作为ATG剂量调整依据及停药标准,观察IP-10组和Scr组ATG疗程、人均日剂量、人均总剂量、严重血小板及中性粒细胞减少发生率、3月内急性排斥反应再发生率、1年内感染发生率。结果:平均用药时间IP-10组(5.35±1.93)d,Scr组(6.70±1.75)d;人均ATG日剂量IP-10组(2.50±0.57)mg(/kg·d),Scr组(2.77±0.74)mg(/kg·d);人均ATG总剂量IP-10组(13.40±6.59)mg/kg,Scr组(18.25±7.35)mg/kg。三项指标两组间均存在显著性差异(P<0.05)。严重血小板及中性粒细胞减少发生率、3个月内急性排斥反应再发生率以及1年内感染发生率两组间无明显差异(P>0.05)。结论:尿IP-10检测法能够有效、可靠指导肾移植术后急性细胞性排斥反应患者ATG使用,降低ATG治疗费用。
OBJECTIVE: To investigate the value of IP-10 in urine after renal transplantation for dose and course evaluation of ATG for acute cellular rejection. Methods: Forty patients with pathologically confirmed acute rejection after kidney transplantation were randomly divided into two groups: IP-10 group (n = 20) and Scr group (n = 20) IP-10 and Scr levels, and then given ATG treatment, and IP-10 and Scr levels were taken as the basis for ATG dose adjustment and withdrawal criteria, IP-10 group and Scr group ATG treatment, per capita daily dose, total per capita dose , Severe thrombocytopenia and neutropenia incidence, recurrence rate of acute rejection within 3 months, 1 year incidence of infection. Results: The mean duration of treatment was IP-10 (5. 05 ± 1.93) d, Scr (6.70 ± 1.75) days, daily ATG daily dose was 2.50 ± 0.57 mg / kg · d ± 0.74) mg (/ kg · d). The total per capita ATG dose was 13.40 ± 6.59 mg / kg in IP-10 group and 18.25 ± 7.35 mg / kg in Scr group. Three indicators of the two groups were significant differences (P <0.05). The incidence of severe thrombocytopenia and neutropenia, the incidence of acute rejection within 3 months and the incidence of infection within 1 year had no significant difference between the two groups (P> 0.05). Conclusion: The urinary IP-10 test can effectively and reliably guide the use of ATG in patients with acute cellular rejection after renal transplantation and reduce the cost of ATG treatment.