CAJ | 학술논문

目的：评估肾移植受者中应用两种不同生物制剂进行免疫诱导治疗的疗效和安全性。方法回顾性分析2008年6月至2013年4月，在解放军第452医院泌尿外科暨成都军区泌尿外科中心应用生物制剂进行免疫诱导治疗的78例尸体肾移植受者的临床资料。根据应用免疫诱导方案不同分为两组，单克隆抗体组（A组，35例，接受巴利昔单抗治疗）和多克隆抗体组[B组，43例，接受抗胸腺细胞球蛋白（ATG）治疗]。另以同期在该院未接受免疫诱导治疗的肾移植受者作为对照组（C组，32例）。分析3组受者术后12周内的人、肾存活情况。监测3组受者术后7、14、30、60 d血清肌酐（Scr）水平变化。比较3组受者急性排斥反应、移植肾功能延迟恢复、感染等并发症的发生率。结果术后12周，3组受体人、肾存活率分别为 A组100％和100％，B组97.7％和97.7％， C组100％和96.9％，各组间比较差异无统计学意义（均为P＞0.05）。术后7、14 d，与C组比较， A组和B组的Scr水平明显下降，差异均有统计学意义（均为P＜0.05）。与C组比较，A、B两组受者急性排斥反应发生率均降低，差异有统计学意义（均为P＜0.05）；3组受者移植肾功能延迟恢复发生率比较，差异无统计学意义（均为P＞0.05）。B组受者术后感染发生率高于A组和C组，差异均有统计学意义（均为P＜0.05）。结论免疫诱导治疗在肾移植受者中应用安全有效。
목적：평고신이식수자중응용량충불동생물제제진행면역유도치료적료효화안전성。방법회고성분석2008년6월지2013년4월，재해방군제452의원비뇨외과기성도군구비뇨외과중심응용생물제제진행면역유도치료적78례시체신이식수자적림상자료。근거응용면역유도방안불동분위량조，단극륭항체조（A조，35례，접수파리석단항치료）화다극륭항체조[B조，43례，접수항흉선세포구단백（ATG）치료]。령이동기재해원미접수면역유도치료적신이식수자작위대조조（C조，32례）。분석3조수자술후12주내적인、신존활정황。감측3조수자술후7、14、30、60 d혈청기항（Scr）수평변화。비교3조수자급성배척반응、이식신공능연지회복、감염등병발증적발생솔。결과술후12주，3조수체인、신존활솔분별위 A조100％화100％，B조97.7％화97.7％， C조100％화96.9％，각조간비교차이무통계학의의（균위P＞0.05）。술후7、14 d，여C조비교， A조화B조적Scr수평명현하강，차이균유통계학의의（균위P＜0.05）。여C조비교，A、B량조수자급성배척반응발생솔균강저，차이유통계학의의（균위P＜0.05）；3조수자이식신공능연지회복발생솔비교，차이무통계학의의（균위P＞0.05）。B조수자술후감염발생솔고우A조화C조，차이균유통계학의의（균위P＜0.05）。결론면역유도치료재신이식수자중응용안전유효。
Objective Toevaluateefficacyandsafetyoftwodifferentbiologicalsinimmunologic inductiontherapyonrenaltransplantrecipients.Methods Clinicaldataof78renaltransplantrecipientswho received biological immunologic induction therapy in Department of Urology of the 452nd Hospital of Chinese People's Liberation Army from June 2008 to April 2013,were retrospectively analyzed. According to different biological immunologic induction therapy,the recipients were divided into two groups,monoclonal antibody group (group A,n=35,received treatment of basiliximab)and polyclonal antibody group [group B,n=43, received treatment of antithymocyte globulin (ATG)]. And the other recipients who didn't receive immunologic induction therapy in the hospital during the corresponding period were chosen as control group (group C,n=32). The survival rates of recipient and kidney in 3 groups at 12th weeks after transplantation were analyzed.The levels of serum creatinine (Scr)of recipients in 3 groups were monitored at 7,14,30,60 d after transplantation. The occurrence rates of complications including acute rejection,delayed graft function and infectionwerecomparedamong3groups.Results At12thweeksaftertransplantation,thesurvivalratesof recipient and kidney in 3 groups were 100% and 100% in group A,97.7% and 97.7% in group B,100%and 96.9% in group C. There was no significant difference among 3 groups (all in P>0.05 ). Compared with group C,the Scr levels in group A and B decreased significantly at 7,14 d after transplantation (all in P<0.05 ). Compared with group C,the incidence rates of acute rejection decreased in group A and B(all in P<0.05 ). There was no significant difference in the incidence rates of delayed graft function among 3 groups (all in P>0.05 ). The incidence rate of infection in group B was significantly higher than those in group A and C (allinP<0.05).Conclusions Immunologicinductiontherapyissafeandeffectiveintheapplicationon renal transplant recipients.