小剂量兔抗人胸腺细胞免疫球蛋白和赛尼哌在肾移植诱导治疗中的应用效果

目的比较小剂量兔抗人胸腺细胞免疫球蛋白（ATG，即复宁）和赛尼哌在肾移植诱导治疗中的应用效果。方法150例尸体肾移植患者分3组，小剂量即复宁组72例（总剂量2．1～3．0mg／kg），赛尼哌组15例（50mg第1、14天各1次），未接受诱导治疗的肾移植受者63例作为对照组。随访6个门，比较3组患者急性排斥反应、DGF发生率和并发肺部感染率。结果即复宁组、赛尼哌组和对照组6个月内发生急性排斥反应分别为4例（5．5％）、1例（6．7％）、10例（15．9％），发生DGF分别为3例（4．2％）．0例、8例（12．7％），并发肺部感染分别为4例（5．1％）、1例（6．7％）、3例（4．8％），发生白细胞减少分别3例（4．2％）、1例（6．7％）、5例（7．9％），发生血小板减少分别2例（2．8％）、1例（6．7％）、5例（7．9％）。结论早期应用小剂最即复宁和赛尼哌是肾移植诱导治疗的合适选择。

Clinical efficacy of small dose of antithymocyte globulin and zenapax in kidney transplant recipients

Objective To evaluate the effects of small dose of antithymocyte globulin(ATG)and zenapax in the induction therapy for kidney transplant recipients.Methods A series of 150 cadaver-donor kidney transplant recipients were randomly divided to 3 groups,ie,small dose of ATG group(total dose,2.1 -3.0 mg/kg;n=72),zenapax group(50mg,on the first and 14th d after operation;n=15)and controls without induction therapy(n=63).Follow-up was 6 months.The rates of acute rejection,delayed graft func- tion(DGF)and pulmonary infection were statistically compared among the 3 groups.Results During a 6-month period,in ATG,zenapax and control groups,acute rejection episodes occurred in 4 cases(5.5%), 1(6.7%)and 10(15.9%),respectively;DGF occurred in 3(4.2%),0 and 8(12.7%),respectively;pul- monary infection occurred in 4(5.1%),1(6.7%)and 3(4.8%),respectively;leucocytopenia occurred in 3(4.2%),1(6.7%)and 5(7.9%),respectively;thrombocytopenia occurred in 2(2.8%),1(6.7%)and 5(7.9%),respectively.Conclusions In the early stage of kidney transplantation,small dose of ATG and zenapax can be the optimal choice for induction therapy.