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急性排斥

急性排斥的相关文献在1978年到2022年内共计223篇,主要集中在外科学、临床医学、基础医学 等领域,其中期刊论文202篇、会议论文6篇、专利文献7152篇;相关期刊107种,包括肾脏病与透析肾移植杂志、中华实验外科杂志、中华肾脏病杂志等; 相关会议6种,包括第五届全军器官移植学术会议、2010全国器官移植学术会议、第七次中国中西医结合泌尿外科学术年会暨第二次广东省中西医结合泌尿外科学术年会等;急性排斥的相关文献由685位作者贡献,包括季曙明、贾保祥、陈江华等。

急性排斥—发文量

期刊论文>

论文:202 占比:2.74%

会议论文>

论文:6 占比:0.08%

专利文献>

论文:7152 占比:97.17%

总计:7360篇

急性排斥—发文趋势图

急性排斥

-研究学者

  • 季曙明
  • 贾保祥
  • 陈江华
  • 傅耀文
  • 王长希
  • 于立新
  • 付绍杰
  • 唐孝达
  • 邓文锋
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 杨进; 张美霞; 闫沛; 程乔; 李建珍
    • 摘要: 背景:研究显示年龄、性别、体质量指数、丙肝感染、免疫抑制药物和糖尿病家族史等是肾移植后新发糖尿病相关的危险因素, 但危险因素对肾移植后新发糖尿病的影响尚存争议.目的:荟萃分析近10年来影响肾移植后新发糖尿病可能相关的危险因素, 为肾移植后新发糖尿病的预防和控制提供参考依据.方法:检索国内外与肾移植后新发糖尿病危险因素相关研究的文献, 检索的数据库包括PubM ed、Embase、Cochrane Library、中国生物医学文献数据库 (CBMdisc), 检索时间限定为2005年1月到2018年5月, 语种限定为中文和英文.由2名评价员按照纳入和排除标准筛选文献并提取资料, 参考Newcastle-OttawaScale质量评价标准进行质量评价, 用RevM an5.3软件进行荟萃分析, 提取影响肾移植后新发糖尿病的危险因素.结果与结论:①21个研究被纳入, 纳入研究的总病例数为8 206例, 其中1 489例发生肾移植后新发糖尿病, 总发病率为18.15%;②经过荟萃分析, 共有7个因素对肾移植后新发糖尿病发病的影响有统计学意义, 其中不可干预的危险因素依次为年龄≥50岁、供肾来源;可干预的危险因素依次为:体质量指数≥25 kg/m2、急性排斥反应、使用他克莫司、丙型肝炎病毒感染、多囊肾;③不能确定是否为肾移植后新发糖尿病危险因素:糖尿病家族史;④结果提示, 年龄> 50岁、供肾来源、体质量指数≥25 kg/m2、急性排斥反应、使用他克莫司、丙型肝炎病毒感染、多囊肾7个因素是肾移植后新发糖尿病的危险因素, 而糖尿病家族史尚不能确定是否为肾移植后新发糖尿病的危险因素.%BACKGROUND: Age, sex, body mass index, hepatitis C infection, immunosuppressive drugs and family history of diabetes mellitus are shown to be risk factors for new-onset diabetes mellitus after kidney transplantation, but their effects remain controversial. OBJECTIVE: To systematically assess the risk factors for new-onset diabetes mellitus after kidney transplantation, so as to provide evidences for preventing and controlling the disease. METHODS: PubMed, Embase, Cochrane Library and CBMdisc databases were searched for the articles concerning risk factors for new-onset diabetes mellitus after kidney transplantation published between January 2005 and May 2018. Two researchers extracted data from each study based on inclusion and exclusion criteria. Quality assessment was conducted in accordance with New castle-Ottawa Scale standard. Meta-analysis was performed on Revman 5.3 software to identify the risk factors for new-onset diabetes mellitus after kidney transplantation. RESULTS AND CONCLUSION: (1) Twenty-one studies involving 8 206 patients were included. There were 1 489 cases of new-onset diabetes mellitus after kidney transplantation, and the morbidity was 18.15%. (2) The meta-analysis identified the following seven significant risk factors, non-modifiable risk factors: age ≥ 50 years, and donor type; modifiable risk factors: body mass index ≥ 25 kg/m2, acute rejection, tacrolimus usage, hepatitis C infection and polycystic kidney. (3) Uncertain risk factor was family history of diabetes. (4) To conclude, age, donor type, body mass index ≥ 25 kg/m2, acute rejection, tacrolimus usage, hepatitis C infection and polycystic kidney are risk factors for new-onset diabetes mellitus after kidney transplantation. But whether the family history of diabetes mellitus is the risk factor remains uncertain.
    • 梁凡; 陈荣卷; 李燕燕; 丁跃中; 许江南
    • 摘要: 目的 建立小鼠原位左肺移植模型,探究抗CD3单抗缓解肺移植急性排斥损伤的作用机制,为其在临床肺移植的应用提供理论依据.方法 选取SPF级野生型BALB/c和C57BL/6小鼠,构建原位左肺移植模型,设置同种同型对照组(C57BL/6→C57BL/6,6只)、同种异型对照组(BALB/c→C57BL/6,6只),同种异型单抗处理组(BALB/c→C57BL/6,4只).术后第2~6天及第9天每日腹腔注射50 g抗CD3单抗.采用苏木精-伊红、马松染色以及CD3/髓过氧化物酶(MPO)免疫组化染色,观察各组移植肺T淋巴细胞和中性粒细胞浸润分布情况,进行急性排斥病理评分;实时荧光定量RT-PCR检测移植肺组织转录因子FoxP3和细胞因子IL-17A、IFN-γ的mRNA表达水平;流式细胞术检测受体小鼠脾脏中FoxP3+调节性T细胞(Treg)占CD4+T细胞的比例.结果 移植术后10天,同种同型组移植肺外观呈淡红色,柔软有弹性,病理学检测未见明显的炎症细胞浸润和组织损伤;同种异型对照组移植肺外观呈绛紫色,硬度增加;同种异型单抗处理组外观淡红柔软,与同种异型对照组比较,淋巴细胞、中性粒细胞浸润显著减少,急性排斥损伤病理评分降低.实时荧光定量RT-PCR结果显示,与同种同型组相比,同种异型组移植肺中IL-17A和IFN-γmRNA的表达水平升高;抗CD3单抗可降低移植肺中IL-17A与IFN-γmRNA表达水平,升高FoxP3mRNA表达水平.流式细胞术结果显示,与同种同型、同种异型对照组相比,单抗处理组小鼠脾脏中Treg占CD4+T细胞的比例显著升高.结论 抗CD3单抗可诱导CD4+FoxP3+Treg的分化并缓解肺移植急性排斥损伤.%Objective By using mouse orthotopic lung transplant model, we investigated the immune mechanisms of an-ti-CD3 induced lung allograft protection .Our study intends to further dissect the features of lung transplant immunology and to provide a novel therapeutic insight for the clinical application of anti-CD3 mAbs after lung transplantation.Methods Murine orthotopic allogeneic lung transplants were performed in C57BL/6 wild type(WT) mice using major histocompatibility complex (MHC) fully mismatched BALB/c donors.Syngeneic transplants were also performed in WT C57BL/6 mice using C57BL/6 donors.For immunosuppressive therapy, allograft recipients received 50g dose of anti-CD3 by intraperitoneal injection on days 2, 3, 4, 5, 6 and 9 post-operation(n=4).At day 10, histopathologic characteristics and rejection status of the pulmonary grafts were assessed.The severity of acute rejection was graded by the pathological score , and T cell and neutrophil infiltration in the pulmonary grafts was evaluated by immunohistochemical(IHC) staining for CD3 and myeloperoxidase(MPO) respective-ly.Real-time RT-PCR was performed for FoxP3, IL-17A and IFN-γexpression in the pulmonary grafts.The percentage of FoxP3+Treg in total CD4+T lymphocytes from the recipient spleens was analyzed by FACS.Results 10 days after transplan-tation, histopathologic examination demonstrated that there is no apparent acute rejection observed in the pulmonary isografts , whereas allografts from untreated recipients have marked inflammatory cell infiltration and pulmonary parenchyma lesion .IHC staining for CD3 and MPO showed that the allograft-infiltrating cells of perivascular layers are mainly T lymphocytes , and the cells around the small airways are mostly neutrophils .Anti-CD3 treatment significantly alleviated the acute rejection of pulmo-nary allografts, when compared with the untreated group.Real-time RT-PCR showed that the expression levels of IL-17A and IFN-γin allografts were markedly elevated compared to those in isografts, and anti-CD3 increased the expression of FoxP3, and reduced the expression of IL-17A and IFN-γin the pulmonary allografts.FACS analysis of splenocytes showed that the percent-age of Treg in total CD4+T lymphocytes increased significantly in the anti-CD3 treated allograft recipients, as compared with the isograft and untreated allograft recipients.Conclusion Anti-CD3 mAbs may alleviate acute rejection of the pulmonary al-lografts by promoting FoxP3 expression and Treg development.
    • 陈丽红; 朱珠; 张丽娜; 何武兵; 曾金华; 刘景丰
    • 摘要: 目的 筛选外周血中能够早期预警肝移植术后急性排斥反应的微小RNA(miRNA,miR).方法 雄性Lewis大鼠40只、BN大鼠80只,分别按体重采用随机数字法分组并采用改良二袖套法构建肝原位移植大鼠模型.免疫耐受组(IT组)采用BN大鼠作为供体,另一BN大鼠为受体;急性免疫排斥组(AR组)采用Lewis大鼠作为供体,BN大鼠为受体;未成熟树突状细胞(imDCs)免疫干预组[转化生长因子-β1(TGF-β1) imDCs组]术法同AR组,受体术前5d腹腔注射2×106个过表达TGF-β1的imDC.术后7d采下腔静脉血进行miRNA基因芯片检测,筛选组间符合差异倍数[FC(abs)] >2.0的差异性表达miRNA.结果 TGF-β1 imDCs组与IT组比较,miR-199a-3p、miR-331-3p和miR-203a-3p显著下调[miR-199a-3p:FC (abs)=27.997,P=0.017;miR-331-3p:FC(abs)=5.403,P=0.034;miR-203 a-3p:FC (abs)=24.593,P=0.022];AR组与TGF-β1 imDCs组比较,miR-199a-3p、miR-331-3p和miR-203 a-3p显著下调[miR-199a-3p:FC (abs)=459.128,P=0.000;miR-331-3p:FC(abs) =9.877,P=0.031;miR-203a-3p:FC(abs) =26.894,P=0.020].以miR-199a-3p的表达差异最为显著[FC(abs) =459.128].结论 肝移植术后大鼠外周静脉血miR-199a-3p的下调可能早期预警急性排斥反应的发生.%Objective To screen microRNAs (miRNA,miR) in the venous blood that could prompt for the occurrence of acute rejection after liver transplantation.Methods Forty male Lewis rats and eighty male BN rats were randomly divided into experimental groups by random number method according to their body weight,and rat liver transplantation model was established by modified two-cuff method.The immune tolerance BN rats [immune tolerance (IT) group] were transplanted with livers from other BN rats.BN rats in the acute immunological rejection group [acute rejection (AR) group] were transplanted with livers from Lewis rats.The immune intervention group [transforming growth factor-β1 (TGF-β1)immature dendritic cells (imDCs) group] were operated as AR group,and intraperitoneally injected 2 × 106 imDCs over-expressed TGF-β15 days before surgery.MicroRNA microarray was used to detect the expression of miRNAs in the venous blood 7 day after operation.The differential expression levels of miRNAs were analyzed by bioinformatics software,and [fold change FC(abs)] > 2.0 served as the threshold value.Results Compared with IT group,miR-199a-3p,miR-331-3p and miR-203a-3p were significantly down-regulated [for miR-199a-3p,FC(abs) =27.997,P=0.017;for miR-331-3p,FC(abs) =5.403,P =0.034;for miR-203a-3p,FC (abs) =24.593,P =0.022].Compared with TGF-β1 imDCs group,miR-199a-3p,miR-331-3p and miR-203a-3p were significantly down-regulated [for miR-199a-3p,FC(abs) =459.128,P=0.000;for miR-331-3p,FC(abs) =9.877,P =0.031;for miR-203 a-3p,FC (abs) =26.894,P =0.020).The differential expression of miR-199a-3p among groups was the most significant [FC(abs) =459.128].Conclusion Downregulation of miR-199a-3p in peripheral blood of rats after liver transplantation may be the early warning of AR.
    • 周守宁; 覃利; 刘思; 刘龙山; 张亦舒; 张桓熙; 王长希; 黄民; 李嘉丽
    • 摘要: The study was designed to investigate the effect of IMPDH1 gene polymorphism on the pharma-codynamics of mycophenolic acid in the renal transplant patients. 315 patients with renal transplantation were treated with triple immunotherapy (mycophenolic acid + tacrolimus + prednisone). The Agena MassARRAY assay was used to detect the IMPDH1 genotypes in patients above. The plasma drug concentration of myco-phenolic acid (MPA) and its main metabolite mycophenolic acid glucuronide (MPAG) was detected by high performance liquid chromatography (HPLC). The correlation between IMPDH1 gene polymorphism (rs10954183,rs12536006, rs13242340, rs2278293, rs2288549) and rejection and postoperative infection in renal transplant recipients were analyzed by SPSS 21 software. The result showed that IMPDH1 rs2288549 GG is a risk factor for acute rejection after renal transplantation (P<0.05), and IMPDH1 rs2278293 CT is a risk factor for infection after renal transplantation (P<0.05). Above all, IMPDH1 rs2288549 is an important factor of acute rejection after renal transplantation, IMPDH1 rs2278293 is an important factor affecting the emergence of infection after renal transplantation. The SNPs may help to optimize clinical medication to reduce the incidence of adverse reaction.%探讨IMPDH1基因多态性对肾移植患者麦考酚酸类药物药效学的影响.纳入315例肾移植术后进行三联免疫疗法(麦考酚酸类药物+他克莫司+泼尼松)的患者.采用Agena MassARRAY?方法检测患者IMPDH1基因型.通过高效液相色谱法检测术后稳定期患者麦考酚酸(MPA)及其主要代谢物麦考酚酸葡萄糖苷酸(MPAG)的血浆药物浓度.应用SPSS 21.0软件对IMPDH1基因多态性(rs10954183、rs12536006、rs13242340、rs2278293、rs2288549)与肾移植患者排斥、术后感染等指标的相关性进行分析.结果显示,IMPDH1 rs2288549 AG型是肾移植患者术后出现急性排斥反应的危险因素(OR=6.629,P<0.05);IMPDH1 rs2278293 CT型是肾移植患者术后出现感染的危险因素(OR=2.812,P<0.05).以上研究表明,IMPDH1 rs2288549是肾移植患者术后出现急性排斥反应的影响因素,IMPDH1 rs2278293是肾移植患者术后出现感染的影响因素,上述SNP可作为参考优化临床用药方案,提高疗效,降低不良反应的发生率.
    • 郑祥韬; 戴驹骥; 徐东宇; 裘益辉; 杨法镜; 虞冠锋
    • 摘要: 目的 探讨一种新型的细胞穿膜肽(PTD)整合的血红素氧合酶-1(HO-1)蛋白对协调性异种心脏移植急性排斥的作用及初步机制.方法 将C57BL/6小鼠心脏移植至Wistar大鼠颈部,建立协调性异种心脏移植模型,将其随机分成单纯移植组(control)、PTD整合荧光蛋白对照组(移植术后腹腔注射PTD-GFP 10mg/d)和PTD-HO-1蛋白治疗组(移植术后腹腔注射PTD-HO-1 1 mg/d),观察移植心脏存活时间.取移植后48h小鼠心脏,HE染色观察心脏组织结构,免疫组化染色观察CD4和CD8阳性T细胞浸润情况,蛋白印记杂交法测定心脏移植物HO-1蛋白的表达.取移植后48 h大鼠血清,ELISA试剂盒检测血清免疫复合物IgM水平及细胞炎症因子IL-2和IFN-γ水平.结果 PTD-HO-1组移植心脏存活时间(6.17±1.17)d明显高于单纯移植组(2.67±0.52)d和PTD-GFP组(2.83±0.41)d,差异有统计学意义(P<0.01).移植术后48 h,PTD-HO-1组移植心脏组织结果破坏程度较其他两组轻,CD4和CD8阳性T细胞浸润情况较其他两组明显减轻,差异均有统计学意义(P<0.01).PTD-HO-1组受体血清IgM、IL-2和IFN-γ水平明显低于其他两组,差异均有统计学意义(P<0.05).而心脏移植物组织内HO-1表达水平明显高于其他两组,差异均具有统计学意义(P<0.01).结论 PTD整合的HO-1蛋白能延长协调性异种移植心脏的存活,为HO-1在异种移植的临床应用提供了可能.
    • 黄桂雄; 黄海波; 李大创; 孙旭勇; 管俊; 曹理政; 杨建均
    • 摘要: 目的探讨BOLD_R2*与DWI_ADC值人体肾移植急性排斥早期诊断价值。方法随机选取正常原位肾33例(A组)、正常移植肾34例(B组)、急性排斥移植肾15例(C组)为研究对象,应用3.0T扫描仪BOLD及DWI序列扫描所有志愿者,将图像输至工作站分析处理。比较三组肾皮质、髓质R2*及与肌肉标准化ADC0-100、ADC0-800值差异性,P<0.05为有统计学差异。以病理为"金标准",评价髓质R2*及与肌肉标准化皮质ADC0-100、ADC0-800值鉴别急性排斥移植肾与移植正常肾、正常原位肾诊断效能。结果 (1)三组间肾髓质R2*差异有统计学意义,两两比较发现C组R2*明显低于与A、B组,A与B组间无统计学差异;三组间肾皮质R2*差异无统计学意义。以病理为标准,髓质R2*=22.7hz为界值,BOLD_R2*区别急性排斥与移植正常肾、原位正常肾ROC曲线下面积为0.981,SE和SP分别为93.3%和100%。(2)三组间肾皮质标准化ADC0-100、ADC0-800值有统计学意义,两两比较除A与B组间差异无统计学意义外其余组间有统计学意义。三组间髓质ADC0-100、ADC0-800值无统计学意义。以病理为标准,取1.249、1.122为界值,标准化皮质ADC0-100、ADC0-800诊断急性排斥移植肾ROC曲线下面积分别为0.947、0.978,SE、SP分别为83.3%、86.7%,91.1%、92.3%。结论 BOLD与DWI在肾移植急性排斥早期诊断中有重要价值,可为后期治疗提供可靠影像依据。
    • 王远涛; 高宝山; 姚立宇; 王伟刚; 周洪澜; 张文岚; 傅耀文
    • 摘要: 目的:探讨肾移植术后围术期及术后6个月应用雷公藤( TW)多苷的临床效果。方法对80例同期肾移植受者进行对照性临床研究,随机分为TW组和未应用TW环孢素( CsA)组各40例。患者术后给予CsA、吗替麦考酚酯及激素三联免疫抑制疗法。观察患者围术期及术后6个月排斥反应发生情况。结果肾移植术后应用TW可以明显降低肾移植术后早期急性排斥发生率,加快患者肌酐恢复至正常的速度,同时降低术后6个月急性排斥反应发生率。结论 TW多苷片可降肾移植早期急性排斥反应发生率,加快患者恢复速度。
    • 陈岚; 吴波; 贺晴; 张稷; 褚超群
    • 摘要: 目的:探讨肺移植受者应用巴利昔单抗诱导治疗的免疫抑制方案疗效.方法:回顾性分析101例肺移植患者,依照入选/排除标准筛选出有效病例73例.其中30例为诱导组,即分别在术中、术后给予两剂巴利昔单抗诱导治疗;另43例为对照组,即不接受诱导治疗.所有患者术后均采用他克莫司、吗替麦考酚酯和泼尼松三联免疫抑制方案预防排斥反应.2组患者均随访12个月,观察排斥反应、代谢并发症的发生以及患者的存活情况.结果:术后1年内,诱导组的急性排斥反应发生率为10%,对照组为33%,两组间差异有统计学意义(P<0.05).诱导组并发症的发生率为63%,对照组为47%,两组间差异有统计学意义(P<0.05).生存分析提示2组患者的半数生存期无统计学差异(P>0.05).结论:以他克莫司为基础的免疫抑制方案中应用巴利昔单抗诱导治疗可以明显降低肺移植术后急性排斥反应发生率,但对肺移植患者的长期存活率没有显著性影响.
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