移植肾急性排斥对慢性排斥的影响因素探讨

IMPACT OF ACUTE REJECTION ON CHRONICREJECTION IN KIDNEY TRANSPLANTATION

移植肾急性排斥对慢性排斥的影响因素探讨中国人民解放军肾脏病研究所季曙明，黎磊石，季大玺，陈惠萍本文研究急性排异（急排）对移植肾慢性排斥（慢排）的影响因素。根据下列指标分组研究：（１）有、无急排；（２）急排发生时间（早期：肾移植后２个月内；晚期：肾移植...

Abstract We assessed the impact of acute renal allograft rejection on the development of chronic rejection and subsequent graft loss. Forty nine patients weredivided into several groups for analysis according to following criteria: 1. The presence or absence of acute rejection, 2. The onset time of acute rejection (early, <2months post transplantation vs late, >2 months posttransplantation), 3. The responsiveness during first acute rejection episode to steroid treatment. The rejectionepisode was diagnosed by percutaneous biopsy of allograft. the results showed thatthe incidence of chronic rejection was 24. 5% in those without acute rejection (N=12) 9 while 33. 3% in those with acute rejection<2 months (N=21, P<0. 01 vs noacute rejection) and 56. 3% in those with acute rejection 2 months (N=16, P<0.01 vs no acute rejection, P<0. 05 vs early acute rejection). The recipients with repeated acute rejection had significantly more chronic rejection than those with only1 rejection(P<0. 05). The incidence of chronic rejection seemed not related to theresponseness of patients to steroid treatment during first time acute rejectionepisode. We concluded that time and frequency of acute rejection may be involved inthe development of chronic rejection and subsequent graft loss.Keywards Acute rejection Chronic rejection