【摘要】 目的观察抗CD3单克隆抗体在预防肾移植术后急性排斥反应的作用。方法164例肾移植患者分为两组,42例移植术后应用抗CD3单克隆抗体(5mgd)为治疗组;其它122例为对照组。观察移植术后人肾存活率、急性排斥反应及CMV感染的发生率。结果治疗组1年、2年及3年人存活率与对照组无显著差异,而治疗组移植肾存活率明显高于对照组(P<005)。治疗组急性排斥反应发生率(119%)比对照组(287%)低(P<005),且首次急性排斥反应发生时间明显延长,对MP冲击治疗效果好。治疗组CMV感染的发生率(333%)高于对照组(P<005)。结论肾移植术后预防性使用抗CD3单克隆抗体对提高移植肾存活率,降低急性排斥反应发生率有较好的作用;用药期间应注意预防及治疗CMV感染。更多还原

【Abstract】 Objective To study the effect of anti-CD₃ monoclonal antibody on preventing acute rejection episodes after renal transplantation. Methods 42 patients undergoing renal transplantation were treated with anti-CD₃ monoclonal antibody（5 mg） daily for a mean of 10 days（treated group）. 122 patients who were not treated with anti-CD₃ monoclonal antibody（control group）. Acute rejection episodes, graft loss, death and rate of CMV infection in patients were observed. Results The treated group had a significantly reduced risk of acute rejection（11.9%）, as compared with the control group（28.7%）. The rate of graft loss were significantly reduced in the treated group 1 year, 2 years, or3 years after renal transplantation. There were no significant defferences in mortality between treated group and control group 1 year, 2 years, or 3 years after renal transplantation. The incidence rate of CMV infection were significantly increased in the treated group（33.3%）, as compared with the control group（13.9%）. The first acute rejection episode was postponed significantly in the treated group. There were more acute rejection episodes that could be reversed by MP in the treated group. Conclusion Anti-CD₃ monoclonal antibody significantly reduced the risk of acute rejection and significantly reduced the rate of graft loss. Anti-CD₃ monoclonal antibody significantly increased the incidence rate of CMV infection, which should be paid attention.更多还原