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目的 观察国产抗CD3单克隆抗体在预防肾移植术后急性排斥反应中的作用。方法 将 6 0例患者随机分为 3组 ,每组 2 0例 ,3个组移植术后均给以环孢素A、硫唑嘌呤和皮质激素组成的三联免疫抑制方案 ;全量组加用抗CD3单克隆抗体 5mg/d ,半量组加用抗CD3单克隆抗体2 .5mg/d ,对照组不用。观察术后肾功能的恢复情况及急性排斥反应发生率。结果 术后 1周使用抗CD3单克隆抗体者的血肌酐低于对照组 (P <0 .0 5 ) ,10d后二者的差异无显著性 ;在术后头 3个月 ,使用抗CD3单克隆抗体治疗组与对照组在急性排斥反应发生率方面的差异有显著性 (P <0 .0 5 ) ;使用抗CD3单克隆抗体全量组与半量组在术后肾功能恢复及急性排斥反应发生率方面的差异无显著性。结论 术后早期预防性使用抗CD3单克隆抗体对移植肾功能的恢复和降低急性排斥反应发生率有较好的作用 ;给予半量的抗CD3单克隆抗体能取得与全量同样的效果 ,且费用较低 ,并发症少
Objective To observe the role of domestic anti-CD3 monoclonal antibody in the prevention of acute rejection after renal transplantation. Methods Totally 60 patients were randomly divided into 3 groups, 20 in each group. All three groups were given triple immunosuppressive regimen consisting of cyclosporine A, azathioprine and corticosteroid. CD3 monoclonal antibody 5mg / d, semi-dose group with anti-CD3 monoclonal antibody 2.5mg / d, the control group without. Postoperative renal function recovery and incidence of acute rejection were observed. Results Serum creatinine was lower in the patients with anti-CD3 monoclonal antibody one week after operation than those in the control group (P <0.05). After 10 days, there was no significant difference between the two groups. In the first 3 months after operation, There was a significant difference in the incidence of acute rejection between the control group and the control group (P <0.05). The use of the anti-CD3 monoclonal antibody in the whole group and the half-dose group after renal function recovery and acute rejection occurred Rate of difference was not significant. Conclusions The prophylactic use of anti-CD3 monoclonal antibody in the early postoperative period may have a good effect on the recovery of renal graft function and reduce the incidence of acute rejection. Half the dose of anti-CD3 monoclonal antibody can achieve the same effect with the same dose, Low, less complications