两剂量赛尼哌对肾移植急性排斥的预防作用

目的研究两剂量赛尼哌对肾移植中急性排斥的预防作用.方法赛尼哌分别在移植前2h和移植后14d给予,术后应用常规三联免疫抑制治疗.结果术后1年时对照组活检证实急性排斥的发生率为22.5%,赛尼哌组急性排斥发生率为6.82%,明显低于对照组.赛尼哌组中肺部感染5例,其中巨细胞病毒(CMV)感染2例,霉菌性肺炎1例,泌尿系感染6例,与对照组比较无显著性差异.使用赛尼哌前后,淋巴细胞变化无明显差异,无发热、头痛、急性肺水肿等细胞因子释放表现.术后1年时赛尼哌组人/肾存活率分别为95.45%/95.45%,对照组人/肾存活率分别为95%/95%.结论两剂量赛尼哌能减少急性排斥的发生,且疗程短,耐受性良好,无细胞因子释放综合征和增加感染并发症.

Prophylaxis for acute rejection by two doses of Zenapax in renal transplantation

Objective To study the prophylaxis for acute rejection with the use of two doses of Zenapax in renal treansplantation. Methods The immunosuppressive therapy consisted of Zenapax and cyclosporin and mycophenolate mofetil(or azathiporine) and corticosteroid. The first dose of Zenapax was given two hours pre-transplantation, and the second dose was given two weeks post-transplantation. Results The biopsy-proven acute rejection was diagnosed in 22.5% of control group at one year post-transplantation, in 6.82% of Zenapax-treated group, The difference between the two groups was significant. The total cases of infection complications in Zenapax-treated group included 5 lung infection, 2 cytomegalovirus infection, 1 fungal infection and 6 urinary infection. There was no significant difference in the numbers of lymphocytes between pre-transplantation and post-transplantation. The tolerance to Zenapax was excellent, with no evidence of cytokine-release syndrome (ie, fever, hypertension, lung oedema, and headache). The patient/graft survival rate in Zenapax-treated group at one year was 95.45%/95.45%, and 95%/95% in control-group. Conclusions The study indicats that Zenapax is an immunosuppressant with a simple administrative regimen. In can reduce acute rejection, and is well tolerated without increase of infections.