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目的探讨血浆置换疗法(PE)对预防肾移植后排斥反应的疗效。方法选择13例肾移植前群体反应抗体(PRA)增高≥30%的患者,在用免疫抑制剂的同时作膜分离法血浆置换。结果PE能清除各种免疫球蛋白及循环抗体,PE前后对比差异有显著性(p<0.01),PE治疗后全部患者(13例)PRA≤10%,肾移植后经过6～9个月的观察,11例(占84%)未出现超急、加速或严重的急性排斥反应;1例出现了急性排斥反应,经透析及药物治疗2周后,移植肾恢复功能;1例出现加速性排斥反应,切除了移植肾。结论PE配合免疫抑制剂治疗,对预防肾移植后排斥反应疗效确切。
Objective To investigate the efficacy of plasma exchange (PE) in preventing rejection after renal transplantation. Methods Thirteen patients with elevated PRA levels ≥30% before renal transplantation were treated with immunosuppressant and plasma exchange was performed by membrane separation. Results PE could clear all kinds of immunoglobulins and circulating antibodies, the difference between before and after PE was significant (p <0.01), PRA≤10% in all patients (13 cases) after PE treatment, after 6 ~ 9 months In 11 cases (84%), there was no hyperacute, accelerated or severe acute rejection. In 1 case, acute rejection occurred. After 2 weeks of dialysis and drug treatment, the graft function recovered and 1 case had accelerated rejection Response, removal of the transplant kidney. Conclusion PE combined with immunosuppressive therapy is effective in preventing rejection after renal transplantation.