CAJ | 학술논문

目的总结应用抗胸腺淋巴细胞球蛋白(ATG)诱导联合标准免疫抑制方案治疗的经验,提高肾移植后人、肾长期存活率.方法回顾性分析1997年1月至2012年1月间1632例次应用ATG诱导联合标准免疫抑制方案的肾移植受者的临床资料.统计术后1、3、5、10、15年人、肾存活率,移植后并发症及其处理原则,及其他影响移植效果的因素.结果肾移植后1、3、5、10、15年的人、肾存活率分别为97.0％和96.7％、93.2％和87.8％、88.2％和77.8％、78.5％和51.7％、40.2％和30.4％.术后急性排斥反应(AR)发生率为9.1％(149例次),移植肾功能恢复延迟发生率7.7％ (126例次),慢性移植肾功能丧失发生率为17.9％(292例次).移植后感染发生率为13.4％(219例次),恶性肿瘤发生率为1.2％(19例).死亡124例,死亡率为7.6％,其中死因为感染占53.2％(66例),心脑血管并发症占33.9％(42例),恶性肿瘤占8.9％(11例).结论应用ATG诱导治疗联合标准三联免疫抑制方案可有效预防肾移植术后早期AR,是提高人、肾长期存活率的有效方法.
목적 총결응용항흉선림파세포구단백(ATG)유도연합표준면역억제방안치료적경험,제고신이식후인、신장기존활솔.방법 회고성분석1997년1월지2012년1월간1632례차응용ATG유도연합표준면역억제방안적신이식수자적림상자료.통계술후1、3、5、10、15년인、신존활솔,이식후병발증급기처리원칙,급기타영향이식효과적인소.결과 신이식후1、3、5、10、15년적인、신존활솔분별위97.0％화96.7％、93.2％화87.8％、88.2％화77.8％、78.5％화51.7％、40.2％화30.4％.술후급성배척반응(AR)발생솔위9.1％(149례차),이식신공능회복연지발생솔7.7％ (126례차),만성이식신공능상실발생솔위17.9％(292례차).이식후감염발생솔위13.4％(219례차),악성종류발생솔위1.2％(19례).사망124례,사망솔위7.6％,기중사인위감염점53.2％(66례),심뇌혈관병발증점33.9％(42례),악성종류점8.9％(11례).결론 응용ATG유도치료연합표준삼련면역억제방안가유효예방신이식술후조기AR,시제고인、신장기존활솔적유효방법.
Objective To summarize the experience of ATG induction combined with standard irnmunosuppression in order to prolong the long-term survival of patient/kidney after renal transplantation.Method The data of renal transplantation in 1632 cases who received renal transplantation from Jan.1997 to Jan.2012 were summarized.The data of the recipients were calculated,such as the 1-,3-,5-,10-and 15-year survival rate of patient/graft,and other factors affecting transplantation outcomes.Results The 1-,3-,5-,10-and 15-year survival rate of patient/graft (％) was 97.0/96.7,93.2/87.8,88.2/77.8,78.5/51.7,and 40.2/30.4 respectively.The incidence of acute rejection (AR) was 9.1％ (149 cases).The incidence of delayed graft function (DGF) was 7.7％ (126 cases).The incidence of chronic graft dysfunction was 17.9％ (292 cases).The incidence of infection and cancer after transplantation was 13.4％ (219 cases) and 1.2％ (19cases) respectively.Mortality of recipients after transplantation was 7.6％ (124 cases).Among the 173 dead cases,53.2％ (66 cases) was caused by infections,33.9％ (42 cases) by cardiovascular complication,and 8.9％ (11 cases) by cancer,respectively.Conclusion The regimen of ATG induction therapy combined with standard triple immunosuppressive therapy can prevent acute rejection effectively in the early period after renal transplantation.It is an effective treatment to improve long-term patient/graft survival.