中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2009年
2期
107-110
,共4页
张波%杨建林%刘凡%巨生产%赵致广%杨增悦%汪涌%马建军%邱建新%保庭毅%王禾
張波%楊建林%劉凡%巨生產%趙緻廣%楊增悅%汪湧%馬建軍%邱建新%保庭毅%王禾
장파%양건림%류범%거생산%조치엄%양증열%왕용%마건군%구건신%보정의%왕화
肾移植%肾功能延迟%穿孔素%粒酶B
腎移植%腎功能延遲%穿孔素%粒酶B
신이식%신공능연지%천공소%립매B
Kidney transplantation%Delayed graft function%Perforin%Granzyme B
目的 探讨尿脱落细胞中穿孔素mRNA、粒酶B mRNA检测在移植肾功能延迟恢复(DGF)诊断中的应用价值. 方法 同种异体肾移植DGF患者24例.男15例,女9例.平均年龄37岁.移植肾活检病理分析病因为输尿管梗阻2例、静脉血栓1例、急性环孢素(CsA)中毒3例、急性肾小管坏死(ATN)7例、ATN合并临界改变2例、ATN合并急性排斥反应(AR)3例、AR 6例.移植术后1～14 d留取24例患者73份晨尿标本,应用竞争RT-PCR方法 对患者尿脱落细胞中穿孔素和粒酶B mRNA进行定量检测,应用SPSS13.0软件进行数据分析,mRNA水平用自然对数值表示.结果 24例患者尿脱落细胞中穿孔素和粒酶B mRNA水平在急性CsA中毒、ATN和其他组分别为(-0.76±0.35)、(-0.89±0.30)、(-0.90±0.15)fg/μg和(-0.53±0.22)、(-0.41±0.17)、(-0.73±0.23)fg/μg,组间厕两比较差异均无统计学意义(P>0.05);ATN合并AR组与单纯AR组分别为(1.20±0.39)、(11.13±0.33)fg/μg和(1.07±0.30)、(1.01±0.19)fg/μg,2组比较差异无统计学意义(P>0.05);ATN合并AR、单纯AR组与急性CsA中毒、ATN和其他组比较差异有统计学意义(P<0.001);2例ATN合并临界改变患者尿中穿孔素和粒酶B mRNA平均值分别为1.22、0.97 fg/μg,与ATN合并AR、单纯AR组相近. 结论 DGF患者尿脱落细胞中穿孔素和粒酶BmRNA水平检测有助于DGF的病因诊断,可作为临界改变是否需要进一步干预性治疗的指标之一.
目的 探討尿脫落細胞中穿孔素mRNA、粒酶B mRNA檢測在移植腎功能延遲恢複(DGF)診斷中的應用價值. 方法 同種異體腎移植DGF患者24例.男15例,女9例.平均年齡37歲.移植腎活檢病理分析病因為輸尿管梗阻2例、靜脈血栓1例、急性環孢素(CsA)中毒3例、急性腎小管壞死(ATN)7例、ATN閤併臨界改變2例、ATN閤併急性排斥反應(AR)3例、AR 6例.移植術後1～14 d留取24例患者73份晨尿標本,應用競爭RT-PCR方法 對患者尿脫落細胞中穿孔素和粒酶B mRNA進行定量檢測,應用SPSS13.0軟件進行數據分析,mRNA水平用自然對數值錶示.結果 24例患者尿脫落細胞中穿孔素和粒酶B mRNA水平在急性CsA中毒、ATN和其他組分彆為(-0.76±0.35)、(-0.89±0.30)、(-0.90±0.15)fg/μg和(-0.53±0.22)、(-0.41±0.17)、(-0.73±0.23)fg/μg,組間廁兩比較差異均無統計學意義(P>0.05);ATN閤併AR組與單純AR組分彆為(1.20±0.39)、(11.13±0.33)fg/μg和(1.07±0.30)、(1.01±0.19)fg/μg,2組比較差異無統計學意義(P>0.05);ATN閤併AR、單純AR組與急性CsA中毒、ATN和其他組比較差異有統計學意義(P<0.001);2例ATN閤併臨界改變患者尿中穿孔素和粒酶B mRNA平均值分彆為1.22、0.97 fg/μg,與ATN閤併AR、單純AR組相近. 結論 DGF患者尿脫落細胞中穿孔素和粒酶BmRNA水平檢測有助于DGF的病因診斷,可作為臨界改變是否需要進一步榦預性治療的指標之一.
목적 탐토뇨탈락세포중천공소mRNA、립매B mRNA검측재이식신공능연지회복(DGF)진단중적응용개치. 방법 동충이체신이식DGF환자24례.남15례,녀9례.평균년령37세.이식신활검병리분석병인위수뇨관경조2례、정맥혈전1례、급성배포소(CsA)중독3례、급성신소관배사(ATN)7례、ATN합병림계개변2례、ATN합병급성배척반응(AR)3례、AR 6례.이식술후1～14 d류취24례환자73빈신뇨표본,응용경쟁RT-PCR방법 대환자뇨탈락세포중천공소화립매B mRNA진행정량검측,응용SPSS13.0연건진행수거분석,mRNA수평용자연대수치표시.결과 24례환자뇨탈락세포중천공소화립매B mRNA수평재급성CsA중독、ATN화기타조분별위(-0.76±0.35)、(-0.89±0.30)、(-0.90±0.15)fg/μg화(-0.53±0.22)、(-0.41±0.17)、(-0.73±0.23)fg/μg,조간측량비교차이균무통계학의의(P>0.05);ATN합병AR조여단순AR조분별위(1.20±0.39)、(11.13±0.33)fg/μg화(1.07±0.30)、(1.01±0.19)fg/μg,2조비교차이무통계학의의(P>0.05);ATN합병AR、단순AR조여급성CsA중독、ATN화기타조비교차이유통계학의의(P<0.001);2례ATN합병림계개변환자뇨중천공소화립매B mRNA평균치분별위1.22、0.97 fg/μg,여ATN합병AR、단순AR조상근. 결론 DGF환자뇨탈락세포중천공소화립매BmRNA수평검측유조우DGF적병인진단,가작위림계개변시부수요진일보간예성치료적지표지일.
Objective To explore the clinical value of the level of granzyme B and perforin mRNA in urine for the diagnosis of renal transplantation patients with delayed graft function (DGF). Methods Twenty-four cases of renal transplantation patients with DGF were included in this study. Seventy-three u-rine specimens were obtained from these patients who received graft biopsies. Among the 24 cases, ureteral obstruction occurred in 2 cases, vascular thrombosis in 1 case, acute CsA intoxication in 3 cases, acute tubu-lar necrosis (ATN) in 7 cases, ATN complicating borderline change in 2 cases, ATN complicating acute re-jection (AR) in 3 cases, AR in 6 cases. Total RNA was isolated from the urinary cells. Messenger RNA (mRNA) encoding the cytotoxic proteins perforin and granzyme B gene were measured with the quantitative polymerase-chain-reaction assay-(RT-PCR). SPSS13.0 software was used for data analysis. Levels of mRNA were log-transformed before analysis. Results The levels of perforin and granzyme B mRNA in u-rine among the ureteral obstruction group, vascular thrombosis group, acute CsA intoxication group and ATN group were very low. There was no significant difference among these groups (P>0.05). However,among the ATN complicating borderline change group 1.22, 0. 97 fg/μg, ATN complicating AR group (1.20±0.39), (1.07±0.30)fg/μg, and AR group(11.13±0. 33), (1.01±0.19)fg/μg, the levels were increased significantly(P<0.001). Conclusion Measurement of mRNA encoding the cytotoxic proteins perforin and granzyme B gene in urinary cells in renal transplantation patients with DGF could be helpful to etiological diagnosis of DGF, and might be used as an index for the appropriate management of the borderline change.
