达昔单抗预防肾移植术后急性排斥反应的效果

Use of anti-Tac monoclonal antibody for prevention of acute rejection in cadave ricrenal transplantation recipients

目的 探讨达昔单抗 (Dac ,赛尼哌 )在预防肾移植术后急性排斥反应中的作用。 方法 2 92例肾移植患者随机分为达昔单抗治疗组 (94例 )与对照组 (198)例 ,分析 2组移植肾功能、急性排斥反应发生情况以及外周血T细胞亚群的变化。 结果 术后 1、6及 12个月时达昔单抗组移植肾功能优于对照组 ,术后 12个月时 2组SCr浓度分别为 (133.2± 4 6 .8)和 (16 5 .7± 5 5 .2 ) μmol/L ,差异有统计学意义 (P <0 .0 5 )。术后 6个月时达昔单抗组急性排斥反应发生率为 2 3.4 % ,对照组为38.4 % ,差异有统计学意义 (P <0 .0 5 ) ;术后 2组CD+ 3 与CD+ 4 表达均下降 ,但差异无统计学意义 (P>0 .0 5 )。 结论 达昔单抗可以降低急性排斥反应发生率 ,改善移植肾功能 ,对T细胞亚群无明显影响。

Objective To investigate the effect of an ti -Tac monoclonal antibody in preventing allograft acute rejection after renal tr ansplantation. Methods 292 patients were randomly divide d into 2 groups:anti-Tac group ( n =94) and control group ( n =198).The rec overy of renal function and occurrence of postoperative rejection and changes in T lymphocyte subtypes were sequentially monitored. Results The renal function in anti-Tac group at 1,6 and 12 months after renal trans plantation was better than that in control group( P <0.05).The serum creatin e was (133.2±46.8)μmol/L in anti-Tac group and (165.7±55.2) μmol/L in contr ol group 12 months after renal transplantation.The occurrence of acute rejection in anti-Tac group 6 months after renal transplantation was 23.4%,while it was 38.4% in control group. There was significant difference between the 2 groups( P <0.05).The CD+ 3 and CD+ 4subtypes decreased in both groups after o peration, but the difference was not significant( P >0.05). Conc lusions The results suggest that anti-Tac monoclonal antibody can r educe the incidence of acute rejection and has no influence on T lymphocyte subt ypes.