巴利昔单抗预防肾移植术后急性排斥反应的临床分析

Prevention of Acute Rejection After Renal Transplantation by Basiliximab Induction Therapy

目的:探讨巴利昔单抗(舒莱)诱导治疗联合其他免疫抑制剂在预防肾移植术后急性排斥反应的临床疗效。方法:回顾分析我院2007年6月到2009年9月96例肾移植患者的临床资料,其中54例患者接受舒莱诱导治疗联合三联免疫抑制剂吗替麦考酚(骁悉,MMF)+他克莫司(普乐可复,FK506)或环孢素A(CsA)+皮质激素治疗(诱导组),另外42例只接受三联免疫抑制治疗(对照组),比较两组间6个月内急性排斥反应及其他不良反应发生情况。结果:术后诱导组急性排斥反应发生9例(16.7%),与对照组13例(30.1%)相比有显著性差异(P<0.05),诱导组肌酐恢复时间[(4.3±1.6)d]较对照组[(5.6±1.9)d]有显著性差异(P<0.05);诱导组肾存活52例(96.2%),与对照组38例(90.4%)相比有显著性差异;两组患者的人/肾存活率、肺部感染发生率的差别均无统计学意义(P>0.05)。结论:舒莱诱导治疗可有效降低急性排斥反应发生率,提高移植肾存活率,且不增加患者肺部感染风险。

Objective： To investigate the effects of Basiliximab induction therapy in conjunction with other immunosuppressive agents in clinical renal transplantation. Methods： The clinical data of 96 kidney transplant cases in our hospital from June 2007 to September 2009 were retrospectively studied, and all cases were divided into two groups as Basiliximab induction group （54 patients） and control group （42 patients）. All the patients were treated by the combination of MMF＋FK506 or Ciclosporin ＋ corticosteroids. The two groups of patients were compared in acute rejection and other side effects or harmful events. Results： The patients were followed up for 1 or 2 years, and acute rejection was occurred in 9 cases （16.7%） in induction group and 12 cases （30.1%） in control group with significant difference （P0.05）. There was significant difference （P0.05） at the creatinine recovery time between the two groups, as （4.3 ±1.6） d in the induction group versus （5.6±1.9） d in control group; Renal survival was found in 43 patients （96.2%） of induction group and 34 patients （90.4%） of control group （P0.05）; There was no significant difference （P0.05） between the two groups in the incidence rate of pulmonary infection and patient survival. Conclusion： Basiliximab induction therapy can effectively reduce the incidence of acute rejection, improve graft survival, and do not increase the risk of pulmomary infection.