CAJ | 학술논문

目的探讨肾移植排斥反应时血浆骨桥蛋白( OPN)水平的变化及意义.方法对46例肾移植受者的临床资料及生物样本进行回顾性分析.根据移植肾组织学检查结果,46例受者被分为3组:移植肾功能稳定,且移植肾组织学检查未显示有排斥反应证据者16例,为非排斥组；移植肾组织学检查证实有急性细胞性排斥反应者22例,为急排组；移植肾组织学检查证实为慢性移植肾肾病(CAN)者8例,为慢排组.另以6名亲属活体供者作为对照组.于移植肾组织样本采集前抽取外周血,用人OPN酶联免疫吸附试验检测试剂盒测定血浆OPN水平,参照Banff 03标准对排斥反应进行分级.结果对照组血浆OPN水平为(12.23±5.95)μg/L,非排斥组稍高,为(19.38±8.23)μg/L,两组间的差异无统计学意义( P＞0.05)；慢排组血浆OPN水平为(27.77±12.27)μg/L,与非排斥组比较,差异无统计学意义(P＞0.05)；急排组血浆OPN水平为(41.84±18.51)μg/L,与非排斥组比较,差异有统计学意义(P＜0.05),与慢排组比较,差异也有统计学意义(P＜0.05).急排组血浆OPN水平与排斥反应的级别具有正相关性(r=0.87,P＜0.05),发生Ⅰa级排斥反应和Ⅱb级排斥反应者间血浆OPN水平的差异有统计学意义(P＜0.05).结论血浆OPN水平变化与急性排斥反应关系密切,其水平高低与排斥反应的级别呈正相关,可以作为诊断移植肾急性细胞性排斥反应、评估其严重程度的一个辅助指标.
목적 탐토신이식배척반응시혈장골교단백( OPN)수평적변화급의의.방법 대46례신이식수자적림상자료급생물양본진행회고성분석.근거이식신조직학검사결과,46례수자피분위3조:이식신공능은정,차이식신조직학검사미현시유배척반응증거자16례,위비배척조；이식신조직학검사증실유급성세포성배척반응자22례,위급배조；이식신조직학검사증실위만성이식신신병(CAN)자8례,위만배조.령이6명친속활체공자작위대조조.우이식신조직양본채집전추취외주혈,용인OPN매련면역흡부시험검측시제합측정혈장OPN수평,삼조Banff 03표준대배척반응진행분급.결과 대조조혈장OPN수평위(12.23±5.95)μg/L,비배척조초고,위(19.38±8.23)μg/L,량조간적차이무통계학의의( P＞0.05)；만배조혈장OPN수평위(27.77±12.27)μg/L,여비배척조비교,차이무통계학의의(P＞0.05)；급배조혈장OPN수평위(41.84±18.51)μg/L,여비배척조비교,차이유통계학의의(P＜0.05),여만배조비교,차이야유통계학의의(P＜0.05).급배조혈장OPN수평여배척반응적급별구유정상관성(r=0.87,P＜0.05),발생Ⅰa급배척반응화Ⅱb급배척반응자간혈장OPN수평적차이유통계학의의(P＜0.05).결론 혈장OPN수평변화여급성배척반응관계밀절,기수평고저여배척반응적급별정정상관,가이작위진단이식신급성세포성배척반응、평고기엄중정도적일개보조지표.
Objective To investigate the change and implication of plasma osteopontin (OPN) levels in renal allograft rejection.Methods The clinical data and biological samples of 46 renal transplant recipients were analyzed rerrospecnvely,including 16 patiens with stable allograft function and no evidence of biopsy-proved rejection (Non-R),22 patients with biopsy-proved acute cellular rejection (ACR),and 8 paients with biopsy-proved chronic allograft nephropathy (CAN).Six living related donors served as healthy controls (HC).Plasma OPN level was determined by using the human OPN ELISA kit.Type and grade of ACR were diagnosed based on Banff 03 classification criteria of renal allograft pathology.The plasma OPN levels were compared among different groups.The assistant diagnostic value of plasma OPN levels in differentiating rejection patients were also evaloated.Results The plasma OPN level in HC,Non-R,CAN and ACR groups was ( 12.23 ±5.95),(19.38±8.23),(27.77± 12.27) and (41.84± 18.51) μg/L,respectively.There was no significant difference in plasma OPN levels among HC,Non-R and CAN groups (P＞0.05),but the OPN levels in ACR group were decreased significantly as compared with Non-R and CAN groups (P＜0.05 ).OPN levels were positively correlated with Banff grading of ACR (P＜0.05).OPN levels were significantly different between grade Ia and grade IIb (P＜0.05).Conclusion The change in plasma OPN level has a relationship with acute rejection.Besides,the plasma OPN levels were also positively correlated with the severity of ACR.Monitoring plasma OPN levels should be useful in predicting and evaluating the severity of ACR in renal transplant recipients.