鼠抗人CD3、CD4单克隆抗体治疗肾移植后急性排斥反应的疗效观察

目的　探讨鼠抗人单克隆抗体预防及治疗尸肾移植后排斥反应的效果。方法　总结和分析了６２ 例肾移植后应用鼠抗人单克隆抗体ＷｕＴ３ 、ＷｕＴ４ 预防及治疗排斥反应的效果、单克隆抗体治疗期间血清游离单克隆抗体水平与受者抗鼠抗体的产生等情况。结果　该抗体对急性排斥反应的总体治愈率为７６ ．１ ％ ， 对耐激素的难治性排斥反应的逆转率达６０ ．７ ％ ； ＣＤ３ 和ＣＤ４ 的抑制效应与血清游离单克隆抗体浓度密切相关； 首次应用单克隆抗体治疗时， 抗体的产生与否及量的多少并不影响疗效； 在单克隆抗体治疗的过程中， ＣＤ４／ＣＤ８ 下降明显者， 排斥逆转的可能性大； 停止治疗后Ｔ 淋巴细胞亚群未恢复正常水平者， 感染率明显上升。结论　ＷｕＴ３ 、ＷｕＴ４ 对肾移植后急性排斥反应， 包括耐激素急性排斥反应具有较为满意的治疗效果。

Application of McAb-T3 and McAb-T4 in patients with renal transplantation

Objective To evaluate the efficacy of McAb T3 and McAb T4 in renal graft rejection. Methods The data of 62 case times receiving McAb T3 and McAb T4 for preventing and treating rejection in renal graft recipients were studied retrospectively, including the soluble monoclonal antibody, the humoral antibody response to a murine monoclonal antibody and T lymphocyte subsets. Results The total cured rate for acute rejection was 76.1% . The reverse of steroid resistant rejection was 60.7% . No correlation between preexisting antibodies and the severity of side effects from monoclonal therapy existed. During the treatment of McAb, the rejection reversion was probable in the patients with markedly decrease of CD4/CD8. If the T lymphocyte subsets didn't return to normal, the infectious rate was obviously increased . Conclusion McAb T3 and McAb T4 had satisfactory therapeutic effects on acute rejection following renal transplantation.