CAJ | 학술논문

背景：免疫抑制剂是通过影响机体的体液免疫和细胞免疫抑制机体的免疫功能来完成抗急性排斥反应，提高人/肾存活率。目的：比较3种免疫抑制诱导剂阿伦单抗、达珠单抗和抗胸腺蛋白在肾移植免疫诱导中的有效性与安全性。方法：运用Cochrane系统评价法，检索1966年至2011年PUBMED，EMBASE等数据库。纳入阿伦单抗、达珠单抗和抗胸腺蛋白3种药物在肾移植中的随机对照试验(RCT)进行Meta分析。结果与结论：9个RCT的777例患者纳入分析，3种药物24个月的人/肾存活率和急性排斥发生率差异无显著性意义(均P >0.05)。随访36个月时，阿伦单抗感染率显著低于抗胸腺蛋白(P<0.05)。分析结果表明，3种药物的免疫诱导效果相近；随访36个月时，阿伦单抗较抗胸腺蛋白的感染率低。
배경：면역억제제시통과영향궤체적체액면역화세포면역억제궤체적면역공능래완성항급성배척반응，제고인/신존활솔。목적：비교3충면역억제유도제아륜단항、체주단항화항흉선단백재신이식면역유도중적유효성여안전성。방법：운용Cochrane계통평개법，검색1966년지2011년PUBMED，EMBASE등수거고。납입아륜단항、체주단항화항흉선단백3충약물재신이식중적수궤대조시험(RCT)진행Meta분석。결과여결론：9개RCT적777례환자납입분석，3충약물24개월적인/신존활솔화급성배척발생솔차이무현저성의의(균P >0.05)。수방36개월시，아륜단항감염솔현저저우항흉선단백(P<0.05)。분석결과표명，3충약물적면역유도효과상근；수방36개월시，아륜단항교항흉선단백적감염솔저。
BACKGROUND:Immunosuppressants fight against acute rejections by influencing humoral and celular immune to suppress the immune function, and then improve patient/renal graft survival. OBJECTIVE:To evaluate the effectiveness and safety of alemtuzumab, daclizumab and antithymocyte globulin in inducing immunosuppression in kidney transplantation. METHODS:The randomized controled trials of alemtuzumab or daclizumabversusATG in kidney tranplantation published from 1966 to 2011 were enroled by searching PubMed and EMBASE using Cochrane systematic review. We colected data and major outcomes. And a meta-analysis was conducted on homogeneous studies. RESULTS AND CONCLUSION: A total of 9 randomized controled trials (777 patients) about kidney transplantation were included. The meta-analysis results showed that the safety items including patient/renal graft survival and acute rejection at a folow-up of 24 months had no statistical differences among the three drugs (al P > 0.05). But there was a significant difference between the infection rates of alemtuzumab and antithymocyte globulin at 36 months of folow-up (P < 0.05). The results indicate that alemtuzumab, daclizumab and antithymocyte globulin are equaly effective in inducing immunosuppression at a folow-up of 24 months in kidney transplantation. However, compared to antithymocyte globulin, alemtuzumab has a lower rate of infection at a folow-up of 36 months.