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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。
Objective To investigate the effect of mouse anti-human monoclonal antibody in the prevention and treatment of rejection after cadaveric kidney transplantation. Methods The effects of anti-human monoclonal antibody WuT3 and WuT4 on rejection after renal transplantation were analyzed and analyzed in 62 cases. The level of serum free monoclonal antibody and the production of anti-mouse antibody in recipients during the course of monoclonal antibody treatment were analyzed. Results The overall cure rate of this antibody to acute rejection was 76. 1%, refractory rejection of hormone-refractory reaction rate of 60. 7%. The inhibitory effect of CD3 and CD4 was closely related to the concentration of serum free monoclonal antibody. Whether monoclonal antibody was used for the first time or not and the quantity of antibody did not affect the efficacy. In the course of monoclonal antibody treatment, CD4 / CD8 decreased significantly, the possibility of reversal of rejection is large; stop the treatment of T lymphocyte subsets did not return to normal levels, the infection rate was significantly increased. Conclusion WuT3 and WuT4 have satisfactory therapeutic effects on acute rejection after renal transplantation, including acute rejection of steroid.