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目的 探讨应用抗淋巴细胞单克隆抗体OKT3预防及治疗肾移植术后急性排斥反应(AR)的效果和安全性、副反应等.方法 对照组128例肾移植患者,术后常规应用甲基泼尼松龙(MP)、强的松(Pred)、硫唑嘌呤(Aza)、骁悉/布累迪宁和环孢素A(CsA)、普乐可复(FK506);实验组36例在上述用药的基础上,术后前10d连续应用OKT310mg,使用前以MP200mg诱导.结果 实验组AR发生时间较对照组明显推迟,其AR发生率明显降低(χ2=4.725,P<0.05).6例耐激素性急性排斥反应(SR AR)应用OKT3治疗,4例逆转,逆转率为66.7%.结论 OKT3作为肾移植术后的预防用药,能减少AR的发生率,并能降低排斥反应的强度,可提高移植肾长期存活率.OKT3作为肾移植AR的治疗用药,能较好的逆转SR AR反应.可使一部分患者避免因AR丧失移植肾.OKT3进入人体能引起首剂综合症等很多副反应,应当引起重视.
Objective To investigate the efficacy and safety of anti-lymphocyte monoclonal antibody OKT3 in preventing and treating acute rejection (AR) after renal transplantation and its side effects.Methods 128 cases of renal transplantation patients were treated with methylprednisolone Prednisone (Pred), Azathioprine (Aza), Sox / Blendine, Cyclosporin A (CsA) and Flecoxib (FK506) On the basis of the medication, OKT310mg was administered continuously 10 days before the operation and MP200mg was used before the operation.Results The incidence of AR in the experimental group was significantly delayed compared with that in the control group, and the incidence of AR was significantly decreased (χ2 = 4.725, P <0.05) OKR3 was used in the treatment of steroid-induced acute rejection (SR AR), while the reversal rate was 66.7% in 4 cases.Conclusion OKT3 can reduce the incidence of AR and reduce the rejection after renal transplantation, Improve the long-term survival of renal allograft.OKT3 as renal transplantation AR treatment can better reverse the SR AR response.May be part of the patient to avoid loss of AR due to renal transplantation.OKT3 into the body can cause many side effects such as the first syndrome, Deserve attention.