CsA顺序用药对肾移植长期存活的影响

The long-term survival effects of sequential use of CsA in kidney transplantation

目的:探讨CsA顺序用药对肾移植长期存活的影响。方法:随机选择32例肾移植患者术后立即应用OKT3,并以同期56例术后立即应用CsA的患者为对照。结果:OKT3组及CsA组急性排斥反应(AR)发生率分别为34.4%和64.3%(P<0.01),难治性排斥反应发生率OKT3组为9.1%,CsA组为30.6%(P<0.05)。术后首次AR发生时间,CsA组为13.1±1.3d,OKT3组为22.5±3.2d(P<0.001)。CsA组和OKT3组4年人存活率相似(分别为85.7%和90.6%),4年肾存活率CsA组为71.4%,OKT3组为87.5%(P<0.05)。结论:CsA顺序用药能显著减少AR及难治性排斥反应发生率,延迟排斥反应发生时间,提高肾移植长期存活率。

Purpose:To inquire into the long term survival effects of sequential use of CsA in kidney transplantation.Methods:OKT 3 or CsA was administered immediately after kidney transplantation to 32 and 56 patients respectively.Results:The morbidity of acute rejection was 34.4 % in OKT 3 group and 64.3 % in CsA group (P< 0.01 ). The incidence of refractory rejection was 9.1 % in OKT 3 group and 30.6 % in CsA group (P< 0.05 ). The mean time to the first acute rejection episode in CsA and OKT 3 group was 13.1 ± 1.3 days and 22.5 ± 3.2 days respectively(P< 0.001 ). Patient survival rate at four years was similar in CsA and OKT 3 groups( 85.7 % and 90.6 % respectively), and graft survival in the same time was 71.4 % in CsA group and 87.5 % in OKT 3 group(P< 0.05 ). Conclusions:Sequential use of CsA could reduce the morbidity of acute and refractory rejection, delayed the time of the first rejection episode occured, and improved the long term survival of transplant kidney.