本文關(guān)鍵詞： 腎移植 間充質(zhì)干細(xì)胞 急性排斥反應(yīng) 臍帶　出處：《福建醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：觀察臍帶間充質(zhì)干細(xì)胞(hU-MSCs)輸注防治移植腎急性排斥反應(yīng)（AR）和促進(jìn)移植腎功能早期恢復(fù)中的有效性和安全性。方法：172例腎移植受者分為hU-MSCs組（121例）和對(duì)照組(51例)，hU-MSCs組于腎移植當(dāng)天和術(shù)后2周時(shí)分別經(jīng)外周靜脈輸注hU-MSCs，對(duì)照組不進(jìn)行任何誘導(dǎo)治療。觀察兩組AR的發(fā)生情況、移植腎功能、免疫抑制劑使用情況，隨訪時(shí)間為12個(gè)月。結(jié)果：兩組患者基本資料的差異無統(tǒng)計(jì)學(xué)意義(P＞0.05)。hU-MSCs組在術(shù)后AR的發(fā)生率分別為9.09％和15.69％，無統(tǒng)計(jì)學(xué)意義(P=0.208)。 hU-MSCs組術(shù)后7d的估算腎小球?yàn)V過率(eGFR)明顯高于對(duì)照組(P＜0.01)，兩組其他時(shí)間點(diǎn)eGFR的差異無統(tǒng)計(jì)學(xué)意義(P＞0.05)。術(shù)后應(yīng)用FK506劑量hU-MSCs組較對(duì)照組明顯減少，差異有統(tǒng)計(jì)學(xué)意義（P0.01）。而CsA的應(yīng)用劑量在術(shù)后2個(gè)月后hU-MSCs組明顯低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P0.05）。兩組移植后感染發(fā)生率的差異無統(tǒng)計(jì)學(xué)意義(P＞0.05)。hU-MSCs組術(shù)后肝功能異常的發(fā)生率為9.92%，低于對(duì)照組的41.18%(P＜0.001)。結(jié)論：術(shù)前hU-MSCs輸注可促進(jìn)移植腎功能早期恢復(fù)，，使用較低劑量的免疫抑制劑就能維持免疫抑制作用減少對(duì)肝臟的毒性且安全性較好。
[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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R699.2

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