巴利昔单抗在儿童肝移植中应用的有效性及安全性评价

Efficacy and safety of basiliximab in pediatric liver transplantation

目的 评价巴利昔单抗在儿童肝移植患者中应用的有效性及安全性.方法 采用回顾性的对照研究方法,将2014年1月1日至2015年12月31日256例实施儿童肝移植的受者按照入选和排除标准筛选后,137例受者使用巴利昔单抗免疫诱导及两联（甲强龙＋他克莫司）抗排斥反应治疗（巴利昔单抗组）,84例受者仅接受常规两联（甲强龙＋他克莫司）治疗（对照组）,比较2组机会感染率、排斥反应发生率和术后3个月内（术后第7天、第14天、第21天、第28天、第56天、第84天）肾功能及电解质的变化情况.结果 与对照组比较,巴利昔单抗组机会感染的发生率高,但2组比较差异无统计学意义（32.8％与27.4％,P＞0.05）;与对照组比较,巴利昔单抗组的排斥反应发生率低,但2组比较差异无统计学意义（8.3％与14.3％,P＞0.05）,2组的尿素氮水平、血肌酐水平、血钾水平、血钙、血磷水平比较,差异均无统计学意义（P＞0.05）.结论 使用巴利昔单抗虽然可降低排斥反应发生率,但效果不显著,可能与样本数不够有关,还有待进一步观察.

Objective To evaluate the safety of basillixirnab in pediatric liver transplantation （PLT）.Methods Retrospectively,256 cases （hospitalized from Jan.2014 to Dec.2015） were divide into groups in terms of inclusion and exclusion criteria.A group of 137 children transplanted under tacrolimus-steroid as baseline immunosuppressants combined with basilliximab induction （basilliximab group）,and a group of 84 PLT recipients were treated with a tacrolimus-steroid regimen （control group） were set up.Two groups were compared regarding rejection incidence,infectious complications,as well as the kidney function and electrolyte within the three months after operations.Results Infectious complications and rejection incidence were 32.8% and 8.3% in basilliximab group,versus 27.4% and 14.3% in control group （all P〉0.05）.There was no statistically significant difference in the levels of blood urea nitrogen,creatinine,calcium,potassium and phosphate between two groups.Conclusion Although basilliximab may decrease the rejection incidence,the effect is not significant.The main reason may be the small sample size,and further observation is still needed.