肾移植中生物免疫制剂应用与术后肺部感染的关系

目的探讨肾移植中巴利昔单抗(舒莱)、抗Tac单抗(赛尼哌)、抗胸腺细胞球蛋白(ATG)等生物免疫制剂应用与术后肺部感染的关系。方法2003年至2005年间肾移植患者417例,男249例,女158例。年龄17～64岁,平均41岁。比较分析生物免疫抑制剂组、环孢素组和他克莫司(FK506)组术后肺部感染的发生率,以及不同生物免疫制剂组间肺部感染发生率的差异。结果417例患者术后发生肺部感染38例(9.1%)。环孢素组(n=224)、FK506组(n=118)和生物制剂组(n=75)肺部感染发生率分别为8.0%、9.3%、12.0%,组间差异无统计学意义(P>0.05)。舒莱组(n=25)、赛尼哌组(n=14)、ATG诱导组(n=16)和ATG治疗组(n=20)肺部感染发生率分别为8.0%、7.1%、6.3%、25.0%,差异无统计学意义(P>0.05)。急性排斥组与未出现排斥组肺部感染发病率分别为20.5%、7.9%,差异有统计学意义(P<0.01),其中单纯应用甲泼尼龙冲击治疗组(n= 19)与ATG治疗组(n=20)间肺部感染发病率分别为15.8%,25.0%,差异无统计学意义(P>0.05)。结论生物免疫制剂舒莱、赛尼哌和ATG并不增加肾移植后肺部感染的危险性。

The relationship of biological agents and respiration infections in kidney transplantation patients

Objective To investigate the relationship of biological agents(anti-thymocyte globu- lin/Basiliximab/daclizurmab)and respiration infections in kidney transplantation patients.Methods The kidney transplant patients from 2003 to 2005 were reviewed.A retrospective comparing of pulmo- nary infections' morbility among the CsA,FK506 and biological agents groups,and inter-biological a- gents groups.Results The morbility of pulmonary infections in this group is 9.1%(38/417).No differences were observed in pulmonary infections morbility among the CsA MMF Pred(n=224), FK506 MMF Pred(n=118)and biological agents groups(n=55)(P>0.05),and the same result was observed inter-biological agents groups(P>0.05).The morbility of pulmonary infections in a- cute rejection group was significantly higher than non acute rejection group (P<0.01),and no differ- ences were observed between Methyllprednisolone and ATG groups (P>0.05).Conclusions The biological agents,such as Anti-Thymoeyte Globulin(ATG),BasiliXimab,Daclizurmab,may not in- crease the incidence of pulmonary infections after kidney transplantation.