中华医学杂志
中華醫學雜誌
중화의학잡지
National Medical Journal of China
2010年
36期
2528-2531
,共4页
靳占奎%田普训%薛武军%丁小明%潘晓鸣%丁晨光%贾利宁%葛冠群%郝军军
靳佔奎%田普訓%薛武軍%丁小明%潘曉鳴%丁晨光%賈利寧%葛冠群%郝軍軍
근점규%전보훈%설무군%정소명%반효명%정신광%가리저%갈관군%학군군
肾移植%HLA抗原%抗原,CD30%移植物排斥%免疫状态
腎移植%HLA抗原%抗原,CD30%移植物排斥%免疫狀態
신이식%HLA항원%항원,CD30%이식물배척%면역상태
Kidney transplantation%HLA antigens%Antigens,CD30%Graft rejection%Immune status
目的 研究肾移植受者血清人类白细胞抗原G5(HLA-G5)、可溶性CD30(sCD30)的表达与移植肾功能的关系,以及联合两者评价肾移植受者免疫状态的最佳诊断阈值、敏感度及特异度.方法 选取2002年1月至2008年11月西安交通大学医学院第一附属医院肾病中心接受同种异体肾移植手术受者66例,其中38例移植肾功能正常,15例为急性排斥反应,13例为慢性排斥反应.检测所有受者血清HLA-G5、sCD30的表达水平;应用受试者工作特征曲线分析HLA-G5联合sCD30评价移植术后1年内及术后1年以上不同免疫状态的最佳临界值、敏感度和特异度.结果 HLA-G5水平与血肌酐水平相关(r=-0.493,P＜0.01),sCD30水平与血肌酐水平相关(r=0.691,P＜0.01).术后1年内,当HLA-G5临界值取82μg/L,sCD30 临界值取12.2μg/L时,评价肾移植受者免疫状态的敏感度为7 8.6%,特异度为85.7%;术后1年以上,当HLA-G5临界值取141μg/L,sCD30临界值取10.3 μg/L时,评价肾移植受者免疫状态的敏感度为92.3%,特异度为84.6%.结论 血清HLA-G5联合sCD30可作为反映肾移植受者免疫状态简便而有效的临床指标.
目的 研究腎移植受者血清人類白細胞抗原G5(HLA-G5)、可溶性CD30(sCD30)的錶達與移植腎功能的關繫,以及聯閤兩者評價腎移植受者免疫狀態的最佳診斷閾值、敏感度及特異度.方法 選取2002年1月至2008年11月西安交通大學醫學院第一附屬醫院腎病中心接受同種異體腎移植手術受者66例,其中38例移植腎功能正常,15例為急性排斥反應,13例為慢性排斥反應.檢測所有受者血清HLA-G5、sCD30的錶達水平;應用受試者工作特徵麯線分析HLA-G5聯閤sCD30評價移植術後1年內及術後1年以上不同免疫狀態的最佳臨界值、敏感度和特異度.結果 HLA-G5水平與血肌酐水平相關(r=-0.493,P＜0.01),sCD30水平與血肌酐水平相關(r=0.691,P＜0.01).術後1年內,噹HLA-G5臨界值取82μg/L,sCD30 臨界值取12.2μg/L時,評價腎移植受者免疫狀態的敏感度為7 8.6%,特異度為85.7%;術後1年以上,噹HLA-G5臨界值取141μg/L,sCD30臨界值取10.3 μg/L時,評價腎移植受者免疫狀態的敏感度為92.3%,特異度為84.6%.結論 血清HLA-G5聯閤sCD30可作為反映腎移植受者免疫狀態簡便而有效的臨床指標.
목적 연구신이식수자혈청인류백세포항원G5(HLA-G5)、가용성CD30(sCD30)적표체여이식신공능적관계,이급연합량자평개신이식수자면역상태적최가진단역치、민감도급특이도.방법 선취2002년1월지2008년11월서안교통대학의학원제일부속의원신병중심접수동충이체신이식수술수자66례,기중38례이식신공능정상,15례위급성배척반응,13례위만성배척반응.검측소유수자혈청HLA-G5、sCD30적표체수평;응용수시자공작특정곡선분석HLA-G5연합sCD30평개이식술후1년내급술후1년이상불동면역상태적최가림계치、민감도화특이도.결과 HLA-G5수평여혈기항수평상관(r=-0.493,P＜0.01),sCD30수평여혈기항수평상관(r=0.691,P＜0.01).술후1년내,당HLA-G5림계치취82μg/L,sCD30 림계치취12.2μg/L시,평개신이식수자면역상태적민감도위7 8.6%,특이도위85.7%;술후1년이상,당HLA-G5림계치취141μg/L,sCD30림계치취10.3 μg/L시,평개신이식수자면역상태적민감도위92.3%,특이도위84.6%.결론 혈청HLA-G5연합sCD30가작위반영신이식수자면역상태간편이유효적림상지표.
Objective To study the relationship between the expression of serum human leucocyte antigen-G5 (HLA-G5)/soluble CD30 (sCD30) and the fuction of renal graft in kidney transplant recipients and investigate the immune status of recipients with combined HLA-G5 and sCD30. Methods From January 2002 to November 2008, a total of 66 kidney transplant recipients in our centre were selected as subjects and divided into three groups: stable function of renal graft (n =38), acute rejection (n= 15) and chronic rejection (n = 13). The expressions of serum HLA-G5 and sCD30 were detected. There were two different immune conditions with acute/chronic allograft rejection and normal renal graft in kidney transplant recipients as evaluated by combined HLA-G5 and sCD30. The sensitivity, specificity and critical value of the method were analyzed by the curve of receiver operating characteristic. Results The levels of HLA-G5 and sCD30 were significantly correlated with serum creatinine ( r = - 0.493, 0.691, both P ＜ 0. 01 ). Within the first year post-transplantation, the sensitivity was 75. 6% and the specificity 85. 7% when HLA-G5critical value 82 μg/L and sCD30 critical value 12.2 μg/L. After one year post-transplantation: the sensitivity was 92. 3% and the specificity 84. 6% when HLA-G5 critical value 141 μg/L and sCD30 critical value 10. 3μg/L. Conclusion The immune state of recipients are evaluated by combine HLA-G5 and sCD30 which may be a simple and valid method.
