CAJ | 학술논문

目的评价静脉注射用人免疫球蛋白(IVIG)辅助治疗肾移植术后肺炎的效果和安全性.方法将60例肾移植术后发生肺炎的患者分为两组,在常规针对病原体治疗(抗细菌、抗病毒、抗真菌)和调整免疫抑制方案的基础上,28例IVIG组患者辅以小剂量免疫球蛋白(0.2 g·kg-1·d-1)治疗.观察IVIG组和对照组患者普通肺炎的治疗有效率和重症肺炎发生率,以及IVIG治疗前后患者血清肌酐水平、血清IgG浓度以及T淋巴细胞亚群的变化,判断不良反应的发生率.结果 IVIG组和对照组患者普通肺炎的治疗有效率分别为100％和93.75％ (P＜0.05),重症肺炎的发生率分别为0和12.5％ (P＜0.05),死亡率分别为0和6.25％ (P＜0.05)；IVIG组治疗后血清IgG浓度显著升高,并明显高于对照组(P＜0.05)；IVIG组未发生明显不良反应.结论肾移植术后肺炎发病早期联合应用IVIG辅助治疗安全有效,能阻止肺炎发展,降低重症肺炎发生率和患者死亡率.
목적 평개정맥주사용인면역구단백(IVIG)보조치료신이식술후폐염적효과화안전성.방법 장60례신이식술후발생폐염적환자분위량조,재상규침대병원체치료(항세균、항병독、항진균)화조정면역억제방안적기출상,28례IVIG조환자보이소제량면역구단백(0.2 g·kg-1·d-1)치료.관찰IVIG조화대조조환자보통폐염적치료유효솔화중증폐염발생솔,이급IVIG치료전후환자혈청기항수평、혈청IgG농도이급T림파세포아군적변화,판단불량반응적발생솔.결과 IVIG조화대조조환자보통폐염적치료유효솔분별위100％화93.75％ (P＜0.05),중증폐염적발생솔분별위0화12.5％ (P＜0.05),사망솔분별위0화6.25％ (P＜0.05)；IVIG조치료후혈청IgG농도현저승고,병명현고우대조조(P＜0.05)；IVIG조미발생명현불량반응.결론 신이식술후폐염발병조기연합응용IVIG보조치료안전유효,능조지폐염발전,강저중증폐염발생솔화환자사망솔.
Objective To investigate the adjunctive therapeutic effects and safety of intravenous immunoglobin (IVIG) for treating pneumonia following kidney transplantation.Methods Sixteen cases of pulmonary infection after kidney transplantation were divided into two groups.Twenty-eight cases were subjected to IVIG therapy (0.2 g·kg-1 ·day-1) for 7-10 days besides the standard specific anti-bacterial,anti-fungal,and anti-virus treatment and regular immunosuppressive regimen with dose adjustment (IVIG group),and the control group was only treated with standard specific anti-pathogen therapy.The incidence and mortality ofsevere pulmonary infection,levels of serum IgG,T lymphocyte subsets,and creatinine in the two groups were observed.Results The effective power of IVIG group and control group was 100 ％ and 93.75 ％ (P＜0.05).The incidence of severe pneumonia in IVIG and control groups was 0 and 12.5％,respectively (P＜0.05),with the mortality being 0 and 6.25％,respectively (P＜ 0.05).The levels of serum IgG were significantly increased in IVIG group as compared with that before treatment and in control group.There were no significant adverse reactions associated with IVIG infusion.Conclusion As an adjunctive therapy,IVIG treatment for pulmonary infection can reduce the incidence of severe pulmonary infection and mortality after kidney transplantation,further increase the survival rate of patients after kidney transplantation.