心脏移植术后免疫诱导预防排斥反应的系统评价

摘要
图/表
参考文献(28)
相关文章 (15)

全文: PDF (799 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的系统评价心脏移植术后免疫诱导预防排斥反应的疗效。方法检索PubMed、Embase、Cochrane Library、中国生物医学文献数据库，收集心脏移植诱导治疗包括抗胸腺细胞免疫球蛋白（ATG）、巴利昔单抗（BAS）等相关文献，时间从建库至2020年3月，主要结果为1年排斥反应率，运用RevMan 5.4软件进行分析。结果最终纳入12项研究，共38 764例。结果显示BAS组1年排斥反应率高于ATG组，差异有统计学意义（OR = 2.03， 95%CI：1.78～2.32，P ＜ 0.01）。ATG组、BAS组和无诱导组1年排斥反应率比较，差异无统计学意义（P ＞ 0.05）。阿仑单抗组1年排斥反应率低于无诱导组，差异有统计学意义（P ＜ 0.05）。结论心脏移植后使用ATG预防1年排斥反应效果优于使用BAS。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	李扬侯震童惟依邓靖飞杨渊▲

关键词 ：心脏移植, 诱导治疗, 排斥, 感染, 生物制剂

Abstract：Objective To systematically evaluate the effect of immune induction on preventing rejection after heart transplantation. Methods PubMed, Embase, Cochrane Library, Chinese Biomedical Literature Database were searched, and related literature on induction therapy of heart transplantation were collected, including antithymocyte immunoglobulin (ATG), basiliximab (BAS). The time from the establishment of the database to March 2020, the main result was the one-year rejection rate, and RevMan 5.4 software was used for analysis. Results Finally, a total of 12 studies were included, with a total of 38 764 cases. The results showed that the one-year rejection rate of the BAS group was higher than that of the ATG group, and the difference was statistically significant (OR = 2.03, 95%CI：1.78-2.32, P ＜ 0.01). There was no statistically significant difference in the one-year rejection rate between the ATG group, the BAS group and the non-induction group (P ＞ 0.05). The one-year rejection rate of the Alemtuzumab group was lower than that of the no-induction group, and the difference was statistically significant (P ＜ 0.05). Conclusion After heart transplantation, the effect on preventing one-year rejection of ATG is better than that of the BAS.

Key words： Heart transplantation Induction therapy Rejection Infection Biological agents

基金资助:中国医学科学院医学与健康科技创新工程项目（2019-I2M-1-002）。

通讯作者: ▲通讯作者

作者简介: 李扬（1979-），女，博士，副研究员；研究方向：医学情报学。

引用本文:

李扬侯震童惟依邓靖飞杨渊▲. 心脏移植术后免疫诱导预防排斥反应的系统评价[J]. 中国医药导报, 2020, 17(35): 72-75.
LI Yang HOU Zhen TONG Weiyi DENG Jingfei YANG Yuan▲. Systematic evaluation of the effect of immune induction after heart transplantation on the prevention of rejection. 中国医药导报, 2020, 17(35): 72-75.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2020/V17/I35/72

[1] Baran DA，Zucker MJ，Arroyo LH，et al. A prospective，randomized trial of single-drug versus dual-drug immunosuppression in heart transplantation：the tacrolimus in combination，tacrolimus alone compared （TICTAC） trial [J]. Circ Heart Fail，2011，4（2）：129-137.
[2] Ensor CR，Cahoon WD，Hess ML，et al. Induction immunosuppression for orthotopic heart transplantation：a review [J]. Prog Transplant，2009，19（4）：333-342.
[3] Costanzo MR，Dipchand A，Starling R，et al. The International Society of Heart and Lung Transplantation Guidelines for the care of heart transplant recipients [J]. J Heart Lung Transplant，2010，29（8）：914-956.
[4] Jadad AR，Moore RA，Carrpll D，et al. Assesing the quaility of reports of randomized clinical trials：is blinding necessary? [J]. Control Clin Trials，1996，17（1）：1-12.
[5] Stang A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in metaanalyses [J]. Eur J Epidemiol，2010，25（9）：603-605.
[6] Mehra MR，Zucker MJ，Wagoner L，et al. A multicenter，prospective，randomized，double-blind trial of basiliximab in heart transplantation [J]. J Heart Lung Transplant，2005， 24（9）：1297-304.
[7] Carrier M，Leblanc MH，Perrault LP，et al. Basiliximab and rabbit anti-thymocyte globulin for prophylaxis of acute rejection after heart transplantation：a non-inferiority trial [J]. J Heart Lung Transplant，2007，26（3）：258-263.
[8] Mattei MF，Redonnet M，Gandjbakhch I，et al. Lower risk of infectious deaths in cardiac transplant patients receiving basiliximab versus anti-thymocyte globulin as induction therapy [J]. J Heart Lung Transplant，2007，26（7）：693-699.
[9] Flaman F，Zieroth S，Rao V，et al. Basiliximab versus rabbit anti-thymocyte globulin for induction therapy in patients after heart transplantation [J]. J Heart Lung Transplant，2006，25（11）：1358-1362.
[10] Emin A，Rogers CA，Thekkudan J，et al. Antithymocyte globulin induction therapy for adult heart transplantation：a UK national study [J]. J Heart Lung Transplant，2011，30（7）：770-777.
[11] Rafiei M，Kittleson M，Patel J，et al. Anti-thymocyte gamma-globulin may prevent antibody production after heart transplantation [J]. Transplant Proc，2014，46（10）：3570-3574.
[12] Martin ST，Kato TS，Farr M，et al. Similar survival in patients following heart transplantation receiving induction therapy using daclizumab vs basiliximab [J]. 2015，79（2）：368-374.
[13] Amin AA，Araj FG，Ariyamuthu VK，et al. Impact of induction immunosuppression on patient survival in heart transplant recipients treated with tacrolimus and mycophenolic acid in the current allocation era [J]. Clin Transplant，2019，33（8）：13651.
[14] Nozohoor S，Stehlik J，Lund LH，et al. Induction Immunosuppression Strategies and Long-Term outcomes after Heart Transplantation [J]. Clin Transplant，2020，13871.
[15] Zhang R，Haverich A，Strüber M，et al. Delayed onset of cardiac allograft vasculopathy by induction therapy using anti-thymocyte globulin [J]. J Heart Lung Transplant，2008，27（6）：603-609.
[16] Teuteberg JJ，Shullo MA，Zomak R，et al. Alemtuzumab induction prior to cardiac transplantation with lower intensity maintenance immunosuppression：one-year outcomes [J]. Am J Transplant，2010，10（2）：382-388.
[17] Gale SE，Ravichandran B，Ton VK，et al. Alemtuzumab Induction Versus Conventional Immunosuppression in Heart Transplant Recipients [J]. J Cardiovasc Pharmacol Ther，2019，24（5）：435-441.
[18] Amlot PL，Rawlings E，Fernando ON，et al. Prolonged action of a chimeric interleukin-2 receptor （CD25） monoclonal antibody used in cadaveric renal transplantation [J]. Transplantation，1995，60（7）：748-756.
[19] Wehrum T，Beume LA，Stich O，et al. Activation of disease during therapy with alemtuzumab in 3 patients with multiple sclerosis [J]. Neurology，2018，90（7）：601-605.
[20] Barr ML，Sanchez JA，Seche LA，et al. Anti-CD3 monoclonal antibody induction therapy. Immunological equivalency with triple-drug therapy in heart transplantation [J]. Circulation，1990，82（5）：291-294.
[21] Rosenberg PB，Vriesendorp AE，Drazner MH，et al. Induction therapy with basiliximab allows delayed initiation of cyclosporine and preserves renal function after cardiac transplantation [J]. J Heart Lung Transplant，2005，24（9）：1327-1331.
[22] Banchs HL，Jiménez EJC，Gonzálezet V，et al. Basiliximab and heart transplantation in Hispanics：the experience in Puerto Rico [J]. Bol Asoc Med P R，2007，99（3）：191-196.
[23] Stapleton DD，Ventura HO，Grundtner SE，et al. Induction immunosuppression with the monoclonal antibody OKT3 after cardiac transplantation [J]. Am J Med Sci，1993， 306（1）：16-19.
[24] Macdonald PS，Mundy J，Keogh AM，et al. A prospective randomized study of prophylactic OKT3 versus equine antithymocyte globulin after heart transplantation--increased morbidity with OKT3 [J]. Transplantation，1993， 55（1）：110-116.
[25] Bonaros N，Dunkle D，Kocher A，et al. Ten-year follow-up of a prospective，randomized trial of BT563/bb10 versus anti-thymocyte globulin as induction therapy after heart transplantation [J]. J Heart Lung Transplant，2006， 25（9）：1154-1163.
[26] Carrier M，Leblanc MH，Perrault LP，et al. Basiliximab and rabbit anti-thymocyte globulin for prophylaxis of acute rejection after heart transplantation：a non-inferiority trial [J]. J Heart Lung Transplant，2007，26（3）：258-263.
[27] Mattei MF，Redonnet M，Gandjbakhch I，et al. Lower risk of infectious deaths in cardiac transplant patients receiving basiliximab versus anti-thymocyte globulin as induction therapy [J]. J Heart Lung Transplant，2007，26（7）：693-699.
[28] Mullen JC，Kuurstra EJ，Oreopoulos A，et al. A randomized controlled trial of daclizumab versus anti-thymocyte globulin induction for heart transplantation [J]. Transplant Res，2014，3：14.