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急性排异反应

急性排异反应的相关文献在1991年到2018年内共计85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77篇、会议论文6篇、专利文献173162篇;相关期刊64种,包括科学中国人、透析与人工器官、医学影像学杂志等; 相关会议5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、2009年全国器官移植学术会议等;急性排异反应的相关文献由267位作者贡献,包括刘卫、丛文铭、何怡华等。

急性排异反应—发文量

期刊论文>

论文:77 占比:0.04%

会议论文>

论文:6 占比:0.00%

专利文献>

论文:173162 占比:99.95%

总计:173245篇

急性排异反应—发文趋势图

急性排异反应

-研究学者

  • 刘卫
  • 丛文铭
  • 何怡华
  • 卢晓芳
  • 夏春燕
  • 姜伟
  • 张惠云
  • 张红安
  • 张莉
  • 李治安
  • 期刊论文
  • 会议论文
  • 专利文献

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    • 卫泽武; 张文文; 马多玲; 毕娟; 谌介秀; 杨云云
    • 摘要: Objective To study the efficacy and adverse reactions for renal transplant patients conversed from cyclospo-rine A to tacrolimus .Methods The follow-up data of renal transplant patients conversed from cyclosporine A to tacrolimus were collected .The clinical therapeutic outcomes including drug induced diseases (DIDs) and acute rejection (AR) induced by cyclosporine A were analyzed during the first year after conversion with SPSS 17 .0 software .Results The levels of Scr and BUN were significantly decreased during the first year after conversion for renal transplant patients with CScr and AR (P<0.05 or P<0 .01) .The levels of direct bilirubin (DB) and total bilirubin (TB) were also significantly lowed (P<0.05 or P<0 .01) during the first year for drug-induced liver injury (DILI) patients .The average level of ALT was significantly decreased in 12 months after conversion (P<0.05) .The complications of gingival overgrowth (GO) stopped with the medication replace-ment .However ,the fasting blood glucose (FBG) level increased significantly in 12 months after conversion (P<0.05) .Con-clusion For renal transplant patients suffered from AR or the serious DIDs induced by cyclosporine A ,conversion from cyclos-porine A to tacrolimus could be considered .However ,it should be aware of the high blood glucose or the new diabetes caused by tacrolimus .%目的 研究肾移植患者用基础免疫抑制剂他克莫司替换环孢素A后的疗效与不良反应.方法 收集他克莫司替换环孢素A的肾移植患者随访资料,使用SPSS17.0分析替换后1年内相关药源性疾病(DIDs)和急性排异反应(AR)的改善情况.结果 肾移植患者用他克莫司替换环孢素A后的1年内,慢性爬行肌酐升高(CScr)者和AR者的血肌酐(Scr)及尿素氮(BUN)均逐渐下降,两者有显著性差异(P<0.05或P<0.01);药物性肝损伤(DILI)者的总胆红素(TB)和直接胆红素(DB)逐渐下降,并呈显著性差异(P<0.05或P<0.01),第12个月转氨酶(ALT)显著降低(P<0.05);牙龈增生(GO)现象停止.然而,空腹血糖(FBG)在第12个月显著升高(P<0.05).结论 使用环孢素A的肾移植患者,若发生环孢素相关的A R和(或)其所致DIDs,可用他克莫司替换,但需警惕换药所致的肾移植后新发糖尿病.
    • 李琼; 任涛; 谢双双; 陈丽华; 沈文
    • 摘要: Objective To investigate the value of diffusion-tensor imaging(DTI) and blood oxygen level-dependent(BOLD) in differentiation acute rejection(AR) and acute tubular necrosis(ATN), and to explore a sensitive, noninvasive strategy of evaluating renal allograft function.Methods A total of51 renal allograft recipients at2-3 weeks after transplantation in Tianjin First Center Hospital were included in this study from May2012 to March2014 and they were examined using a fat-saturated echo-planar DTI and GRE-BOLD sequence in oblique-coronal orientation at3.0 Tesla magnetic resonance(MR) imager(diffusion directions=6,b=0.300 s/mm2). All patients were divided into three groups: normal renal function group, acute rejection group and acute tubular necrosis group, and the AR and ATN groups were confirmed by pathological biopsy. Mean apparent diffusion coefficient(ADC) and mean fractional anisotropy(FA) and apparent spin-spin relaxation rate(R2*) values of the cortex and medulla were determined separately and comparisons of parameters between the3 groups were tested by one-way ANOVA analysis. Meanwhile, the receiver operating characteristic(ROC) curves was used to compare the differential diagnostic efficacies of every parameters in AR group and ATN group for determine the best diagnostic threshold.Results Compared with normal group, mean ADC value in cortex, mean ADC value in medulla and medullary R2* value of AR group were significantly lower〔mean ADC value in cortex(×10-3mm2/s):2.31±0.49 vs. 2.85±0.28, mean ADC value in medullar(×10-3mm2/s):2.21±0.50 vs.3.07±0.38,medullary R2* value(1/s):19.5±3.3 vs.22.7±3.3,allP0.05). ROC curves revealed that the cut-off values of cortical ADC, medullary ADC and medullary R2* in differentiation AR and ATN were 2.68×10-3 mm2/s,2.73×10-3 mm2/s and21.4/s respectively. Both sensitivity and specificity were higher than70%. The three parameters had comparable power in differentiating ATN and AR allografts(P>0.05).Conclusion DTI and BOLD can identify transplanted renal AR and ATN noninvasively, and mean R2* value in the medulla, mean ADC value in the cortex and medulla can be used as index for differentiating.%目的:探讨扩散张量成像(DTI)、血氧水平依赖成像(BOLD)对移植肾急性排异反应(AR)和急性肾小管坏死(ATN)鉴别诊断价值,以期探寻无创、敏感的评价移植肾功能的方法。方法选取2012年5月—2014年3月在天津市第一中心医院进行异体肾移植术后2~3周的患者51例纳入本研究,所有受试者均于Siemens MAGNETOM Trio Tim3.0T超导磁共振扫描仪进行常规磁共振成像(MR)及脂肪抑制平面回波斜冠状面DTI检查(在6个非共线性方向上施加扩散敏感梯度场,b值为0.300 s/mm2)及斜冠状面BOLD检查。患者分为三组:移植肾功能正常组、AR组及ATN组,其中AR组与ATN组均经病理穿刺证实。分别测量并计算各组移植肾皮质、髓质的表观扩散系数(ADC)值、各向异性分数(FA)值及表观自旋-自旋弛豫率(R2*)值,采用单因素方差分析比较移植肾各组间各参数值的差异。采用受试者工作特征曲线(ROC)比较皮髓质ADC值及R2*值对AR组以及ATN组的鉴别诊断效能并确定最佳诊断阈值。结果与正常组相比,AR组皮质ADC值、髓质ADC值、R2*值显著下降〔皮质ADC值(×10-3mm2/s):2.31±0.49比2.85±0.28,髓质ADC值(×10-3mm2/s):2.21±0.50比3.07±0.38,R2*值(1/s):19.5±3.3比22.7±3.3,均P<0.05〕。与ATN相比,AR组皮质ADC值、髓质ADC值、R2*值显著下降〔皮质ADC值(×10-3mm2/s):2.31±0.49比2.85±0.27,髓质ADC值(×10-3mm2/s):2.21±0.50比2.76±0.35, R2*值(1/s):19.5±3.3比23.6±2.8,均P<0.05〕;三组之间皮质、髓质FA值及皮质R2*值均无明显差异(P>0.05)。皮质ADC值、髓质ADC值及髓质R2*值对AR组与ATN组鉴别的最佳诊断阈值分别为2.68×10-3mm2/s、2.73×10-3mm2/s、21.4/s,其敏感性和特异性均在70%以上,鉴别诊断效能均无明显统计学差异(P>0.05)。结论 DTI、BOLD能无创、有效鉴别移植肾AR与ATN,其中皮髓质ADC值及髓质R2*值可作为鉴别诊断指标。
    • 范文骏; 黄黎香; 沈文
    • 摘要: Current methods in clinic have more or less deficiencies in monitoring and evaluating functional abnormalities of transplants after kidney transplantation. Magnetic resonance diffusion imaging, including diffusion weighted imaging (DWI) and diffusion tensor imaging (DTI), can detect pathophysiological changes in tissues not only in morphological level, but also in microstructural level, such as water molecular diffusion and micro-perfusion. Application of DWI and DTI in assessment of renal function has demonstrated broad prospects. This article aims to review both the application basis of DWI and DTI in kidney as well as research progress of DWI and DTI in functional assessment of transplants.%目前临床上常用的监测及评估肾移植术后移植肾功能的方法均有不足之处,而MR扩散成像包括扩散加权成像(DWI)和扩散张量成像(DTI),能从形态学以及水分子扩散、组织微灌注等微观结构层面无创性地反映组织病理生理变化,在评价肾脏功能方面具有广阔的应用前景。对DWI和DTI在肾脏的应用基础和两者在移植肾功能评价方面的研究进展进行综述。
    • 谷孝艳; 何怡华; 李治安; 薛超; 潘泽雁; 韩建成; 张烨
    • 摘要: 目的 与心内膜心肌活检对比,探讨组织多普勒成像在监测心脏移植术后急性排异反应方面的价值.方法 根据心肌活检结果将心脏移植患者分为3组:0级为B组,Ⅰ级为C组,≥Ⅱ级为D组;设30例志愿者为A组.对所有研究对象进行组织多普勒参数测量,数据进行组间比较.结果 与对照A组相比,心脏移植患者的组织多普勒参数值均明显降低(P<0.05).B组与C组比较:数值没有明显变化.发生排异反应的D组与B组、C组比较:Em峰、Sm峰、舒张早期时间Tem减低具统计学意义(P<0.05).结论 超声组织多普勒成像能在早期敏感地检测出Ⅱ级或大于Ⅱ级急性排异反应,可以作为监测心脏移植术后急性排异反应的筛查方法,从而减少心内膜心肌活检次数.%Objective To observe the acute rejection reaction after heart transplantation (HT) by Tissue Doppler imaging (TDD , comparing with pathology to evaluate the value of Tissue Doppler imaging technique in detecting acute rejection reaction after heart transplantation. Methods 30 endomyocardial biopsies were taken from 25 HT patients. 30 age-matched studies comprised group A. TDI studies were obtained in each patient, and Data were compared Among groups. Results Tissue Doppler imaging showed that peak early diastolic wall motion velocity (Em), Peak late diastolic wall motion velocity( Am) , peak systolic wall motion velocity (Sm) and early diastolic time(Tem) decreased significantly in group D compared to B and C. There was not significant difference between group B and C. Conclusions Echocardiography especially Tissue Doppler imaging is an effective and sensitive technique for the detection of acute rejection with grade≥ Ⅱ after cardiac transplantation.
    • 张莉; 张惠云; 刘卫
    • 摘要: 目的:探讨肝移植术后早期急性排异反应的预防及护理方法.方法:对64例原位肝移植术后应用免疫抑制剂抗排异反应的患者采取综合观察与护理,总结预防及护理急性排异反应发生的经验.结果:本组9例患者术后出现急性排异反应,经积极诊治与护理,急性排异反应得到有效控制并好转出院.结论:急性排异反应一般发生在肝移植术后早期,特别是在第5~14天,完善的术前准备、严密的术后监护、对病情的密切观察及对免疫抑制剂的充分了解,可以有效预防急性排异反应的发生,实施积极有效地护理可有效控制急性排异反应,提高患者生活质量.
    • 赵静
    • 摘要: 急性排异反应(AR)是肾移植术后早期最常见的并发症,也是导致移植肾功能丧失的主要原因,其病理改变可引起移植肾血流灌注的变化,此为国内外研究的热点.超声是监测肾移植术后AR的重要方法,可提供移植肾解剖、血流等信息,其中超声造影在评价移植肾微循环灌注方面具有非常重要的作用,有望使移植肾AR的检测从定性、半定量水平发展到定量水平,提高超声检查的特异性和敏感性.%Acute rejection(AR) is the most common complication in early period after renal transplantation, and it is also the main cause of renal function loss. The pathological changes of AR are related with blood flow perfusion of transplanted kidney. Ultrasound takes important parts in diagnosis of AR by providing the anatomical and blood flow information of transplanted kidney. Contrast-enhanced ultrasound( CEUS) is a new technique in evaluating renal blood flow perfusion, which is expected to achieve a quantitative level in detection of AR and improve the specificity and sensitivity of ultrasound in diagnosis of
    • 朱建平; 孙立; 徐荣全
    • 摘要: 目的 探讨移植肾急性排异(AR)反应的声学造影图像、时间-强度曲线(TIC)以及曲线参数变化的意义.方法 采用编码反相脉冲谐波造影技术,观察30例肾功能稳定期、18例AR受检者的造影图像,分析两组受检者造影效果、TIC及曲线参数值之间的差异.结果 移植肾AR组,造影剂分布不均,肾轮廓清晰度降低,整个移植肾的造影剂充填较肾功能稳定组稀疏(P< 0.05),造影剂上升时间约(12.3±2.05)s,平均通过时间约(65.8±21.6)s、排空时间约(280±23.4)s,TIC第二峰低平与肾功能稳定组比较P<0.05.结论 移植肾发生急性排异反应时,造影显影效果、TIC质量不同程度降低,造影剂灌注时间、排空时间延长.
    • 张莉; 张惠云; 刘卫
    • 摘要: 目的:探讨肝移植术后早期急性排异反应的预防及护理方法。方法:对64例原位肝移植术后应用免疫抑制剂抗排异反应的患者采取综合观察与护理,总结预防及护理急性排异反应发生的经验。结果:本组9例患者术后出现急性排异反应,经积极诊治与护理,急性排异反应得到有效控制并好转出院。结论:急性排异反应一般发生在肝移植术后早期,特别是在第5-14天,完善的术前准备、严密的术后监护、对病情的密切观察及对免疫抑制剂的充分了解,可以有效预防急性排异反应的发生,实施积极有效地护理可有效控制急性排异反应,提高患者生活质量。
    • 龙伟; 杨广庭; 姜伟; 刘彦斌; 裴向克; 白玉梅; 托娅; 张春媛
    • 摘要: BACKGROUND: After the allogeneic kidney transplant operation, acute rejection is one of the most important reasons of transplant kidney hypofunction and eventually defunctionalization. So effective prevention, early diagnosis and acute rejection therapy are important things which relate closely to how long the patient can live.OBJECTIVE: To summarize the experience of application of immunosuppressive on patients with acute rejection in one month after kid ney transplantation .METHODS: A total of 12 kidney transplantation patients were selected, who are all the first time to do the transplant. After the kidney transplantation, using mycophenolate mofetil capsules, cyclosporine A and methylprednisolone as triple regimen to prevent rejection. During 3 to 30 days after operations, the 12 patients had different clinical manifestation, such as hypourocrinia,kidney transplanted area swollen, serum creatinine increase, urine protein increase, instituted as acute rejection after renal transplantation. First, the patients were treated with methylprednisolone pulse therapy: 5mg/d (d1-3), intravenous drip. Then,taking it orally instead, 24 mg/d, decreasing by 4 mg every 5-7 d, until 8 mg/d.RESULTS AND CONCLUSION: 12 cases reversed successfully, including 6 cases which reversed by methylprednisolone.Those unable to reverse were treated with Antithymocyte Globulin (ATG) or CD3. In 1 of 4 cases with ATG, urinary output increased rapidly within 8 hours, 2 cases within 24 hours and 1 case within 72 hours. One case with CD3, patient's urinary output rose quickly within 48 hou rs. One case used tacrolimus instead of cyclosporine A, at the same time took mycophenolate mofetil capsules and methylprednisolone. After the above treatments, kidney function in all 12 cases recovered gradually. The results suggested that, for patients with acute rejection after kidney transplantation, early detection, diagnosis and timely therapy is the key to reversal successfully.%背景:同种异体肾移植后发生的急性排斥反应是移植肾功能减退和最终移植肾丧失的最主要原因之一.有效预防和早期发现与治疗急性排异反应是关系到肾脏移植患者能否长期存活的重要问题.目的:总结肾移植后1 个月内急性排异反应患者治疗过程中免疫抑制剂的应用体会.方法:选择首次肾移植患者12 例,移植后采用霉酚酸酯+环孢素A+甲泼尼龙三联预防排异反应.当肾移植后3~30 d 内出现尿量减少、移植肾区胀痛不适、血肌酐升高、尿蛋白增加等不同临床表现,确诊为肾移植后急性排斥反应时,先选用甲强龙500 mg/d 静脉滴注,连续3 d.然后改甲泼尼龙24 mg 口服1 次/d,每5~7 d 递减4 mg,至8 mg/d 维持.结果与结论:12 例患者成功逆转,其中6 例甲强龙冲击疗法成功;不能逆转者选用抗胸腺细胞球蛋白或CD3 治疗.4 例经抗胸腺细胞球蛋白治疗患者中1 例8h 内尿量迅速增加,2 例24 h 内尿量迅速增加,1 例72 h 后尿量迅速增加;1 例选用CD3 治疗48 h 内尿量迅速增加;1 例将环孢素转换为他克莫司治疗,同时服用霉酚酸酯胶囊和甲泼尼龙片.经以上治疗12例患者肾功能逐渐恢复.提示肾移植后早期发现、早期诊断、及时治疗是急性排异反应成功逆转的关键.
    • 宋洁; 李辉; 张晓东; 李瑛
    • 摘要: 背景:细胞凋亡在移植免疫和移植物功能丧失发生过程中起十分重要的作用,其中Fas/FasL 系统被认为是细胞凋亡参与肾移植的急性排异反应过程的主要途径之一.目的:分析肾移植受者术后血清sFas 和sFasL 水平变化及其在预测早期急性排异反应中的应用价值.方法:肾移植受者80 例分为肾功能稳定组(49 例)、急性排斥反应组(23 例)和环孢素A 中毒组(8 例).另选择性别、年龄与肾移植受者相匹配的健康体检者50 例为对照组.肾移植受者术后均常规使用环孢素A+硫唑嘌呤+泼尼松三联免疫抑制治疗.发生急性排斥反应时给予每日甲基强的松龙6~8 mg/kg 冲击治疗,3 d 为1 个疗程.采用ELISA 法检测患者手术前后的血清sFas 和sFasL 水平.结果与结论:肾移植组患者手术前的血清sFas 和sFasL 水平均明显高于对照组(P < 0.05).急性排斥反应组血清sFas、sFasL水平高于相同时间段肾功能稳定组(P < 0.05).环孢素A 中毒的肾移植患者术后各时间点血清sFas、sFasL 水平变化与肾功能稳定组基本相同,差异无显著性意义.提示动态监测血清sFas、sFasL 水平可能对早期诊断及鉴别诊断肾移植急性排斥反应具有重要参考价值.%BACKGROUND: Apoptosis of target cells plays a crucial effect on acute rejection after organ transplantation. Fas/Fas ligand (FasL) system is considered as one of action pathways of acute rejection after organ transplantation.OBJECTIVE: To study the serum soluble Fas and soluble FasL levels of renal graft recipients in early post-transplant period and their application as a predictor of acute renal allograft rejection.METHODS: The sequential monitoring of serum soluble Fas and soluble FasL levels in 80 patients was conducted by ELISA technique before and after renal transplantation and the relationship between sFas/sFasL with acute renal allograft rejection were analyzed.RESULTS AND CONCLUSION: The levels of serum soluble Fas and soluble FasL in the patients for renal transplantation were significantly higher than that in control before operation (P < 0.05). The levels of serum soluble Fas and solu ble FasL in acute rejection group at same time were significantly higher than that in normal group after operation (P < 0.05), and compared with that in CsA-induced nephrotoxicity group, there was no significant difference. The sequential monitoring of serum solu ble Fas and soluble FasL in renal allograft recipients may be of a useful value to make early and differential diagnosis of acute renal rejection.
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