巴利昔单抗在预防肾移植后排斥反应中的应用

目的:探讨巴利昔单抗诱导治疗预防肾移植后急性排斥反应的有效性和安全性。方法:在使用环孢素、霉酚酸酯及激素三联抗排斥的基础上,将42例肾移植受者随机分2组,每组各21例,试验组术前30min及术后d4各给予巴利昔单抗20mg+氯化钠注射液100mL,静脉滴注,对照组只使用氯化钠注射液静脉滴注。评价急性排斥反应的发生率、严重程度以及巴利昔单抗治疗的安全性。结果:试验组急性排斥反应发生率10%(2/21),发生时间(2.8±s0.8)mo;对照组发生率29%(6/21),发生时间(1.1±0.7)mo,早于试验组(P<0.01)且严重程度高于试验组。血肌酐恢复正常的时间试验组(4.0±0.7)d,对照组(7.8±1.6)d,P<0.01。不良反应发生率2组间差异无显著意义,P<0.05。结论:巴利昔单抗联合环孢素、霉酚酸酯和激素预防肾移植后急性排斥反应安全有效。

Application of basiliximab in prevention of acute allograft rejection in kidney transplantation recipients

AIM: To explore the validity and security of basiliximab induction immunosuppressive therapy in terms of prevention for acute allograft rejection in kidney transplan tation. METHODS: A total of 42 patients were equally randomized into tw o groups treated with either basiliximab or placebo (saline). All patients recei ved immunosuppressive therapy with cyclosporine, mycophenolate mofetil (MMF) and steroids as the basic treatment. RESULTS: No significant differences in patient characteristics were obviously shown. The incidence of acute rejection was 10 % (2/21) in the basiliximab grou p compared with 29 % (6/21) in the placebo group. There was a reduction in incid e nce of steroid-resistant first rejection episodes requring antibody therapy in the patients who received basiliximab. The occurrence and severity of acute rejection in the basiliximab group at (2.8±s0.8) mo were later and milder than those in the placebo group ((1.1±0.7)mo, P<0.01). Renal function impr oved more rapidly in the basiliximab group ((4.0±0.7)d vs (7.8±1.6)d of th e placebo group, P<(0.01)). The incidences of infection and other adverse reac tions were similar for the two groups (P>0.05). CONCLUSION: Basiliximab in combination with cyclosporine, MMF and steroids triple therapy is highly effective in reducing the incidence of acute allograft rejection without increasing the incidence of infections and other adverse reac tions.