半剂量OKT3能逆转移植肾耐激素型急性排异

HALF DOSE OKT3 IS EFFECTIVE IN THE TREATIMENT OF STEROIDRESISTANT ACUTE RENAL ALLOGRAFT REJECTION

目的：了解半剂量ＯＫＴ３能否逆转移植肾耐激素型急性排异（ＳＲ－ＡＲ）。方法：对发生ＳＲ－ＡＲ的肾移植受者，采用半剂量ＯＫＴ３治疗，并与全剂量ＯＫＴ３组对照，观察两组的ＳＲ－ＡＲ的逆转率及并发症发生率。结果：半剂量ＯＫＴ３组（ｎ＝１８）ＳＲ－ＡＲ逆转率为８８．９％，ＣＭＶ病发生率为３８．９％、发热６６．７％、寒颤２２．２％、恶心１６．７％、腹泻１１．１％，与全剂量ＯＫＴ３组（ｎ＝７）相比，两组ＳＲ－ＡＲ逆转率及上述各种发生率间差异均不显著，（Ｐ＞０．０５）。结论：半剂量ＯＫＴ３能逆转ＳＲ－ＡＲ。

OBJECTIVE To examine the efficacy of half dose OKT3 (2.5 mg) in the treatment of steroidresistant acute renal allograft rejection.METHODOLOGY 25 renal graft recipients who developed steroidresistant acute renal allograft rejection(SRAR) were included in this study. 18 were treated with half dose OKT3 (2.5 mg per day for 10.4±3.1 days) and 7 with full dose OKT3 (5 mg per day for 10.2±2.8 days). RESULTS Reversal rate of SRAR was 88.9% in the halfdose OKT3 treated SRAR patients (16 in 18). The incidence of CMV infection, fever, shiver, nausea and diarrhea in halfdose OKT3 treated SR-AR patients were 38.9%, 66.7%, 22.2%, 16.7%, 11.1% respectively. There was no significant difference in the SRAR reversal rate or the incidence of complications between the halfdose and the full dose OKT3 treated patients.CONCLUSION Treatment with half dose OKT3 is an effective approach for SRAR.