移植肾亚临床排斥反应早期诊治的临床意义

Clinical significance of early diagnose and treatment of subclinical renal allograft rejection

目的探讨对移植肾亚临床排斥反应进行早期诊断、早期治疗的临床意义。方法选择术后3个月无临床症状、肾功能正常的同种异体肾移植患者96例(男54例,女42例),平均年龄为37.5岁(17～58岁),以彩色多普勒检查结果为诊断依据,分为正常组和异常组(亚临床排斥组),异常组给予甲基强的松龙冲击治疗和调整免疫抑制剂的剂量,随访观察两组移植肾的存活率。结果经过3年的随访,两组病人移植肾的存活率无明显差异性。结论早期诊断和治疗移植肾亚临床排斥反应,对提高移植肾的长期存活率有重要的临床意义。

Objective To explore the clinical significance of early diagnose and treatment of subclinical renal allograft rejection. Methods Ninety-six renal allografl recipients （54 male and 42 female） with normal renal function aged 17 to 58 years （mean 37.5 years） were included in this study. Early subclinical rejection was diagnosed 3 months after the transplantation by color Doppler examination. Results Patients with early subclinical rejection were given methylpredisolone followed by adjustment of immunosuppressive regimens, and no difference was observed in 3-year survival rate between these patients and those with normal renal aUografl findings. Conclusion Early diagnosis and treatment of subclical renal allografl rejection is significant to improve renal aUografl survival rate.