肾移植中2剂舒莱和2剂赛尼哌对外周血可溶性白细胞介素-2受体水平的影响及意义

目的:探讨2剂舒莱和2剂赛尼哌在尸体肾移植中对外周血可溶性白细胞介素2受体(sIL2R)水平的影响及意义。方法:105例首次接受尸体肾移植的受者随机分为舒莱组、赛尼哌组和对照组,所有受者术后均接受普乐可复或环孢素A加骁悉加泼尼松三联疗法。另外舒莱组在术前2h、术后4天静脉滴注20mg舒莱,赛尼哌组在前24h、术后7天静脉滴注50mg赛尼哌。检测各组术前及术后每周共8周外周血中sIL2R水平变化,记录2个月内急性排斥(AR)的例数。结果:舒莱和赛尼哌组外周血中sIL2R水平分别在术后8周和3周内比对照组低(P<0.05)。术后第4～6周舒莱组比赛尼哌组低(P<0.05)。在术后2个月内,舒莱组、赛尼哌组和对照组发生急性排斥反应的例次分别为1、9、17例,各组比较差异有统计学意义(P<0.05)。结论:2剂舒莱对外周血中sIL2R的抑制及抗急性排斥反应效果比2剂赛尼哌好。

Effect and significance of therapy with two-dose basiliximab versus daclizumab on sIL-2R levels of recipients of cadaveric renal transplantation in the peripheral blood

Objective:To investigate the effect and significance of therapy with two-dose basiliximab versus daclizumab on sIL-2R levels of recipients of cadaveric renal transplantation in the peripheral blood.Methods:105 recipients were retrospectively divided into basiliximab? daclizumab group and control group. Main immunosuppressive therapy regimen consisted of steroids, acrolimus or cyclosporine and mycophenolate mofetil in all recipients after operation. Basiliximab group received 2-dose basilicimab (20mg)intravenous infusion on day 0 and 4 days additionally. Daclizumab group received 2-dose daclizumab (50mg)intravenous infusion on day 0 and 7 days. The number of acute rejection (AR) during two months follow-up, the sIL-2R levels of three groups 0-8 weeks after transplantation were observed and tested. Results:During two months follow-up the number of acute rejection episode was 1 in basiliximab group, 9 in daclizumab group,17 in control group, and the difference between them was significant(P< 0.05). sIL-2R levels of daclizumab group and basiliximab group in the peripheral blood, respectively, were lower than contral group within 3 weeks and 8 weeks(P< 0.05). There was a low express of sIL-2R level in basiliximab groupversus daclizumab group during the 4th to 6th weeks (P< 0.05).Conclusions:The prophylaxis efficacy of 2-dose basiliximab is better than that of 2-dose daclizumab on resisting the sIL-2R levels and preventing AR after renal transplantation.