IL-2R单克隆抗体诱导疗法对移植肾功能延迟恢复的影响

Effects of induction with IL-2R monoclonal antibody on the delayed functional recovery of transplanted kidney

目的探讨IL-2R单克隆抗体诱导疗法对移植肾功能延迟恢复(DGF)的影响。方法回顾分析183例2004年1月-2006年1月在移植中心行首次同种异体尸肾移植病例,根据是否应用IL-2R单抗诱导疗法,将其分为诱导组79例和对照组104例,分析比较两组患者的DGF发生率,以及两组DGF患者的治疗和随访情况。结果诱导组和对照组间的DGF发生率无显著性差异(17.7%vs23.1%,P>0.05)。但诱导组DGF患者并发急性排斥反应(AR)的发生率明显低于对照组DGF患者(0%vs25%,P<0.05),且诱导组DGF患者的1年移植肾存活率高于对照组DGF患者(92.9%vs62.5%,P<0.05)。结论IL-2R单抗诱导疗法对DGF的预防作用不显著,但可以有效降低DGF期间发生AR的风险,改善DGF患者的移植肾存活情况。

Objective To discuss the effects of induction with anti-interleukin-2-receptor （IL-2R） monoclonal antibody on the delayed graft function （DGF）, defined by the need for dialysis in the first week after renal transplantation. Methods Clinical data of 183 patients, who received cadaveric renal transplantation for the first time from Jan. 2004 to Jan. 2006 in the authors＇ hospital, were retrospectively analyzed. Recipients were divided into two groups based on whether they received IL-2R monoclonal antibody： 79 cases were induded in the induction group, and 104 cases were included in the control group. The incidence of DGF, the treatment effectiveness and the follow up results were then compared between the two groups. Results There was no significant difference in the incidence of DGF between induction group and control group （17. 7% vs 23. 1%, P〉0. 05）. During the DGF period, there was a lower incidence of acute rejection in the induction group compared with that in the control group （0% vs 25%, P〈0.05）. One year graft survival rate of DGF patients was significantly higher in the induction group compared with that in the control group （92. 9% vs 62.5%, P〈0. 05）. Conclusion No significant effect of induction treatment with IL-2R monoclonal antibody in the prevention of DGF in renal transplantation patients has been found. However, the induction treatment with IL-2R monoclonal antibody may reduce the incidence of acute rejection in the patients during the period of DGF, and improve the graft survival of renal transplantation in the patients with DGF.