双剂量单克隆抗体在肾移植免疫诱导治疗中的应用研究

Applicative study on two doses of monoclonal antibody for immune induction therapy in kidney transplantation

目的探讨双剂量巴利昔单抗、达利珠单抗在肾移植免疫诱导治疗中的疗效及安全性。方法对比性分析282例肾移植受者的临床资料,其中应用巴利昔单抗诱导124例,达利珠单抗诱导80例,78例未接受免疫诱导者为对照组。所有肾移植受者术后均采用常规免疫抑制方案抗排斥治疗。对不同组受者术前的一般情况及术后肾功能恢复、移植受者/肾存活率及早期并发症的发生情况等进行对照研究。结果巴利昔单抗组与达利珠单抗组的急性排斥反应、早期移植肾功能恢复、1年的移植受者/肾存活率比较差异无统计学意义(P>0.05),均优于对照组(P<0.05);巴利昔单抗组与达利珠单抗组感染及相关并发症发生率与对照组相似(P>0.05)。结论临床应用双剂量单克隆抗体类生物制剂抗体诱导治疗是安全、有效的,但应严格遵守适应证和禁忌证,采取个体化的免疫诱导疗法,积极预防相关并发症,有利于减少排斥反应的发生,提高移植受者/肾的存活率。

[Objective] To investigate the effects and safety of two doses Basiliximab and Daclizumab for immune induction therapy in kidney transplantation. [Methods] Comparative analysis of 282 clinical data of kidney transplant recipients, including Basiliximab- Induced 124 cases, Daclizumab- Induced 80 cases and 78 cases have not accepted immune induction therapy as the control group. All recipients after kidney transplantation were accepted conventional immunosuppressive regimens of exclusion treatment. General situation of different groups in patients with preoperative and postoperative graft function recovery, the survival rate of patients and kidneys within one year and early complications were analyzed and compared. [Results] There was no significant difference in the acute rejection incidence, early graft function recovery, the survival rate of patient and kidney within one year between Basiliximab group and Daclizumab group （P 〉0.05）, but which were better than eontrol group （P 〈0.05）; The infections and assoeiatedeomplications incidenee of Basiliximab group and Daclizumab group were similar to eontrol group （P 〉0.05）. [Conclusion] It is safe and effective for prompting clinieal application of two doses monoelonal antibody-based biologies for immune induction therapy, but should strictly observe the indications and contraindications, preventing assoeiated complications, which may effectively reduce the incidence of rejection and enhanee the survival rate of patient and kidney.