脐带间充质干细胞在肾移植免疫诱导治疗的临床应用研究

发布时间：2018-03-02 03:26

本文关键词： 肾移植间充质干细胞急性排斥反应脐带　出处：《福建医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：观察脐带间充质干细胞(hU-MSCs)输注防治移植肾急性排斥反应（AR）和促进移植肾功能早期恢复中的有效性和安全性。方法：172例肾移植受者分为hU-MSCs组（121例）和对照组(51例)，hU-MSCs组于肾移植当天和术后2周时分别经外周静脉输注hU-MSCs，对照组不进行任何诱导治疗。观察两组AR的发生情况、移植肾功能、免疫抑制剂使用情况，随访时间为12个月。结果：两组患者基本资料的差异无统计学意义(P＞0.05)。hU-MSCs组在术后AR的发生率分别为9.09％和15.69％，无统计学意义(P=0.208)。 hU-MSCs组术后7d的估算肾小球滤过率(eGFR)明显高于对照组(P＜0.01)，两组其他时间点eGFR的差异无统计学意义(P＞0.05)。术后应用FK506剂量hU-MSCs组较对照组明显减少，差异有统计学意义（P0.01）。而CsA的应用剂量在术后2个月后hU-MSCs组明显低于对照组，差异有统计学意义（P0.05）。两组移植后感染发生率的差异无统计学意义(P＞0.05)。hU-MSCs组术后肝功能异常的发生率为9.92%，低于对照组的41.18%(P＜0.001)。结论：术前hU-MSCs输注可促进移植肾功能早期恢复，，使用较低剂量的免疫抑制剂就能维持免疫抑制作用减少对肝脏的毒性且安全性较好。
[Abstract]:Objective: to observe the efficacy and safety of umbilical cord mesenchymal stem cells (hU-MSCs) infusion in the prevention and treatment of acute renal allograft rejection and the early recovery of renal function. Methods: 172 cases of renal transplantation recipients were divided into hU-MSCs group (n = 121) and control group (n = 121). 51 cases of hU-MSCs were injected with hU-MSCs via peripheral vein on the day of renal transplantation and 2 weeks after transplantation, while the control group did not undergo any induction therapy. The occurrence of AR in the two groups was observed. Graft function, use of immunosuppressants, Results: there was no significant difference in basic data between the two groups (P > 0.05). The incidence of AR in group A was 9.09% and 15.69, respectively. There was no significant difference in incidence of AR between two groups. The estimated glomerular filtration rate in hU-MSCs group was significantly higher than that in group hU-MSCs 7 days after operation. Compared with the control group (P < 0.01), there was no significant difference in eGFR between the two groups at other time points (P > 0.05). The postoperative FK506 dosage of hU-MSCs group was significantly lower than that of the control group. The dose of CsA in hU-MSCs group was significantly lower than that in control group 2 months after operation. There was no significant difference in the incidence of postoperative infection between the two groups (P > 0.05). The incidence of abnormal liver function in group A was 9.92, which was lower than that in group B (41.18% P < 0.001). Conclusion: preoperative infusion of hU-MSCs can promote the early recovery of renal transplantation. Lower doses of immunosuppressants can maintain immunosuppressive effects to reduce liver toxicity and are safe.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R699.2

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