小剂量兔抗人胸腺细胞免疫球蛋白与抗人T细胞猪免疫球蛋白在肾移植诱导治疗中的比较

肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (6): 530-535.

小剂量兔抗人胸腺细胞免疫球蛋白与抗人T细胞猪免疫球蛋白在肾移植诱导治疗中的比较

出版日期:2012-12-28 发布日期:2012-12-31

Effect of low dose of Thymoglobulin and ALG-P in the induction therapy for kidney transplant recipients.

Online:2012-12-28 Published:2012-12-31

摘要/Abstract

摘要：

【摘要】目的：比较小剂量兔抗人胸腺细胞免疫球蛋白（即复宁）与抗人T细胞猪免疫球蛋白（ALG-P）在肾移植诱导治疗中的效果。方法：120例首次肾移植受者随机分为三组：对照组40例；ALG-P组36例；小剂量即复宁组44例。随访1年，比较三组外周血T淋巴细胞绝对值、肾功能恢复程度、过敏反应发生情况、继发感染与急性排斥发生率、肾功能延迟恢复（DGF）发生率、血白细胞和血小板变化等。结果：ALG-P组、小剂量即复宁组与对照组相比，外周血T淋巴细胞绝对值下降更为明显，特别是CD4+T淋巴细胞，在术后3d、9d、1月、3月、6月均能更明显下降（P<0.05）；同时急性排斥反应发生时间延迟，1周内无急性排斥反应发生，急性排斥反应及DGF发生率更低（P<0.05），肾功能恢复情况更好（P<0.05）；虽然有过敏反应的发生及血小板严重下降的发生率增加（P<0.05），但并未导致严重后果。小剂量即复宁组与ALG-P组相比，在肾移植术后早期（术后3月内）外周血T淋巴细胞绝对值下降更为明显，特别是CD4+T淋巴细胞，在术后3d、9d、1月、3月均有更明显下降（P<0.05）；小剂量即复宁组急性排斥反应及DGF发生率更低，肾功能恢复情况更好；继发感染、过敏反应、血小板和白细胞等严重下降的发生率两组无明显区别（P>0.05）。结论：小剂量即复宁、ALG-P在肾移植免疫诱导治疗的使用中是安全而有效地；小剂量即复宁与ALG-P相比，效果更佳，可作为免疫抑制诱导治疗的更优选择。

Abstract:

ABSTRACT Objective：To evaluate the effects of low dose of thymoglobulin and ALG-P in the induction therapy for kidney transplant recipients. Methodology: One hundred twenty cases with first kidney transplant were randomly divided into 3 group: low dose of thymoglobulin group (n=44)；ALG-P group（n=36）and control group （n=40）. Follow-up was 1 year. The peripheral T—lymphyote absolute counts, graft function recovery, allergic reaction, the rates of infection and acute rejection, the rates of delayed graft function （DGF）, and the change of leukocytes and platelets were statistically compared among the three groups. Results: The peripheral T-lymphyote absolute counts were decreased more significantly in ALG-P group and low dose of thymoglobulin group, especially CD4+T Lymphocyte, at third, 9th, 1, 3, and 6 month postoperative, were decreased more significantly. Compare with control group, the delayed acute rejection and no acute rejection in one week，the rate of acute rejection and delayed graft function were more lower, graft function recovery were better, the rate of allergic reaction, the decrease of platelets were more significantly，but not leaded to severe consequence. Compare with ALG-P group, in low dose of Thymoglobulin group, the peripheral T-lymphyote absolute counts were decreased more significantly postoperative early (within three months after transplantation), especially CD4+T Lymphocyte, at third、9th、one and three month postoperative were decreased more significantly (P<0.05). The rate of acute rejection and delayed graft function were more lower (P<0.05), graft function recovery was better, the rate of allergic reaction, and the decrease of leukocytes and platelets were no differences between two groups (P>0.05). Conclusions: ALG-P and low dose of Thymoglobulin are effective and safe in induction therapy for kidney transplant recipients which can be the optimal choice for induction therapy. Compare with ALG-P group, low dose of Thymoglobulin group was decreased more significantly the rate of acute rejection and delayed graft function, and graft function recovery was better.

冯小芳，王立明，闵敏，等. 小剂量兔抗人胸腺细胞免疫球蛋白与抗人T细胞猪免疫球蛋白在肾移植诱导治疗中的比较[J]. 肾脏病与透析肾移植杂志, 2012, 21(6): 530-535.

FENG Xiao-fang，WANG Li-ming，MIN Min，et al. Effect of low dose of Thymoglobulin and ALG-P in the induction therapy for kidney transplant recipients.[J]. Chinese Journal of Nephrology, Dialysis & Transplantation, 2012, 21(6): 530-535.

ISSN 1006-298X CN 32-1425/R