小剂量抗CD_3单克隆抗体治疗肾移植术后早期急性排斥反应的临床研究

Clinical research of using low-dose monoclonal antibody-CD_3 (OKT_3 )on treatment of early acute graft rejection episodes after kidney transplantation

目的探讨应用小剂量抗CD3单克隆抗体(OKT3)治疗肾移植术后早期急性排斥反应的效果和安全性。方法将33例发生早期急性排斥反应的肾移植病人分为两组,A组16例(OKT35mg/d);B组17例(OKT32.5mg/d)。观察排斥反应逆转情况及感染的发生率。结果A组13例(81.25%)急性排斥反应逆转,移植肾功能恢复正常;1例移植肾自发性破裂行移植肾摘除术,2例移植肾失功恢复血液透析。B组15例(88.24%)急性排斥反应逆转,移植肾功能恢复正常;1例移植肾自发性破裂行移植肾摘除术,1例移植肾失功恢复血液透析。两组排斥反应逆转率无显著性差异(P>0.05)。A组合并感染43.75%,B组5.88%;两组比较有显著性差异(P<0.05)。结论小剂量OKT3治疗肾移植术后早期急性排斥反应的效果良好,并发症少,且费用较低。

Objective:To investigate the effect and reliability of using low-dose OKT3on the treatment of early acute graft rejection episodes after renal transplantation.Methods:33patients with early acute graft rejection episodes were randomly divided into two groups:group A(n=16)receiving OKT 3 5mg/d;group B(n=17)receiving OKT 3 2.5mg/d.It was observational to acute graft rejection reverse rate and occurrence rate of infection.Results:Acute graft rejection were reversed and the recovery normal of graft function81.25%in group A and88.24%in group B,but no significant difference(P>0.05).Group A and group B had one case the graft was eventually re-moved because of spontaneous rupture.Two cases in group A and one case in group B occurred early graft function failures to recover the blood dialysis.A significant difference in combination of infection was seen between group A and group B[43.75%and5.88%,P<0.05].Conclusions:Low-dose OKT 3 on the treatment of early acute graft re-jection episodes is good,and the complications is little,and the expenses is lower.