中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2012年
7期
392-396
,共5页
林衔亮%王栋%罗流涛%谭建明
林銜亮%王棟%囉流濤%譚建明
림함량%왕동%라류도%담건명
肾移植%CD30抗原%移植物排斥%肺部感染
腎移植%CD30抗原%移植物排斥%肺部感染
신이식%CD30항원%이식물배척%폐부감염
Kidney transplantation%Antigens,CD30%Graft rejection%Infection
目的 分析肾移植受者术前可溶性CD30 (sCD30)水平与术后急性排斥反应(AR)、肺部感染以及移植肾功能丧失等临床事件的相关性,探讨利用术前sCD30水平对肾移植受者进行术前风险评估的可行性.方法 将有完整5年随访资料的586例肾移植受者纳入研究.采用酶联免疫吸附试验法检测受者术前sCD30的水平,根据sCD30水平将受者分为高水平组(sCD30＞240 U/ml)、中水平组(sCD30为120～240 U/ml)、低水平组(sCD30＜120 U/ml).比较3组间AR和肺部感染的发生率以及术后5年受者和移植肾的存活率,分析术前sCD30水平与透析时间以及术后发生AR和肺部感染间的相关性.结果 肾移植受者术前sCD30水平显著高于正常健康人群(P＜0.01).随访5年内,低水平组、中水平组和高水平组的AR发生率分别为17.4％(45/259)、29.2％(77/264)和42.9％(27/63),肺部感染发生率分别为20.8％,8.3％和15.9％,3组间AR和肺部感染发生率的两两比较,差异均有统计学意义(P＜0.01).发生AR者的术前sCD30水平为(180.0±89.1)U/ml,明显高于未发生AR者的(135.3±72.7)U/ml( P＜0.01)；发生肺部感染者术前sCD30水平为(123.2±75.5) U/ml,显著低于未发生肺部感染者的(150.7±79.6)U/ml( P＜0.01).术前sCD30水平与AR的发生呈正相关(相关系数=0.242,P＜0.01),与肺部感染的发生呈负相关(相关系数=-0.147,P＜0.01).高水平组受者和移植肾5年累积存活率分别为79.4％和69.8％,明显低于低水平组的90.3％和87.3％及中水平组的91.3％和87.6％ (P＜0.05,P＜0.01),而后两组间的差异均无统计学意义(P＞0.05).结论 肾移植受者术前sCD30水平与术后AR和肺部感染的发生具有明显的相关性,可以独立预测术后AR,肺部感染事件及移植肾功能丧失的风险.
目的 分析腎移植受者術前可溶性CD30 (sCD30)水平與術後急性排斥反應(AR)、肺部感染以及移植腎功能喪失等臨床事件的相關性,探討利用術前sCD30水平對腎移植受者進行術前風險評估的可行性.方法 將有完整5年隨訪資料的586例腎移植受者納入研究.採用酶聯免疫吸附試驗法檢測受者術前sCD30的水平,根據sCD30水平將受者分為高水平組(sCD30＞240 U/ml)、中水平組(sCD30為120～240 U/ml)、低水平組(sCD30＜120 U/ml).比較3組間AR和肺部感染的髮生率以及術後5年受者和移植腎的存活率,分析術前sCD30水平與透析時間以及術後髮生AR和肺部感染間的相關性.結果 腎移植受者術前sCD30水平顯著高于正常健康人群(P＜0.01).隨訪5年內,低水平組、中水平組和高水平組的AR髮生率分彆為17.4％(45/259)、29.2％(77/264)和42.9％(27/63),肺部感染髮生率分彆為20.8％,8.3％和15.9％,3組間AR和肺部感染髮生率的兩兩比較,差異均有統計學意義(P＜0.01).髮生AR者的術前sCD30水平為(180.0±89.1)U/ml,明顯高于未髮生AR者的(135.3±72.7)U/ml( P＜0.01)；髮生肺部感染者術前sCD30水平為(123.2±75.5) U/ml,顯著低于未髮生肺部感染者的(150.7±79.6)U/ml( P＜0.01).術前sCD30水平與AR的髮生呈正相關(相關繫數=0.242,P＜0.01),與肺部感染的髮生呈負相關(相關繫數=-0.147,P＜0.01).高水平組受者和移植腎5年纍積存活率分彆為79.4％和69.8％,明顯低于低水平組的90.3％和87.3％及中水平組的91.3％和87.6％ (P＜0.05,P＜0.01),而後兩組間的差異均無統計學意義(P＞0.05).結論 腎移植受者術前sCD30水平與術後AR和肺部感染的髮生具有明顯的相關性,可以獨立預測術後AR,肺部感染事件及移植腎功能喪失的風險.
목적 분석신이식수자술전가용성CD30 (sCD30)수평여술후급성배척반응(AR)、폐부감염이급이식신공능상실등림상사건적상관성,탐토이용술전sCD30수평대신이식수자진행술전풍험평고적가행성.방법 장유완정5년수방자료적586례신이식수자납입연구.채용매련면역흡부시험법검측수자술전sCD30적수평,근거sCD30수평장수자분위고수평조(sCD30＞240 U/ml)、중수평조(sCD30위120～240 U/ml)、저수평조(sCD30＜120 U/ml).비교3조간AR화폐부감염적발생솔이급술후5년수자화이식신적존활솔,분석술전sCD30수평여투석시간이급술후발생AR화폐부감염간적상관성.결과 신이식수자술전sCD30수평현저고우정상건강인군(P＜0.01).수방5년내,저수평조、중수평조화고수평조적AR발생솔분별위17.4％(45/259)、29.2％(77/264)화42.9％(27/63),폐부감염발생솔분별위20.8％,8.3％화15.9％,3조간AR화폐부감염발생솔적량량비교,차이균유통계학의의(P＜0.01).발생AR자적술전sCD30수평위(180.0±89.1)U/ml,명현고우미발생AR자적(135.3±72.7)U/ml( P＜0.01)；발생폐부감염자술전sCD30수평위(123.2±75.5) U/ml,현저저우미발생폐부감염자적(150.7±79.6)U/ml( P＜0.01).술전sCD30수평여AR적발생정정상관(상관계수=0.242,P＜0.01),여폐부감염적발생정부상관(상관계수=-0.147,P＜0.01).고수평조수자화이식신5년루적존활솔분별위79.4％화69.8％,명현저우저수평조적90.3％화87.3％급중수평조적91.3％화87.6％ (P＜0.05,P＜0.01),이후량조간적차이균무통계학의의(P＞0.05).결론 신이식수자술전sCD30수평여술후AR화폐부감염적발생구유명현적상관성,가이독립예측술후AR,폐부감염사건급이식신공능상실적풍험.
Objective To analyze the pre-transplant sera of renal graft recipients for soluble CD30 level and study the correlation between sCD30 level and acute rejection (AR),lung infection or renal graft loss.To investigate the feasibility of sCD30 level for pre-transplant risk evaluation in renal transplant recipients.Methods 586 renal graft recipients were enrolled into this study,who had complete 5-year follow-up data and sufficient pre-transplant sera for analysis.Pre-transplant sera were collected for detection of sCD30 level by ELISA and patients were divided into three groups according to sCD30 level:group L (sCD30＜120 U/ml),group I (sCD30 120-240U/ml) and group H (sCD30 ＞240 U/ml).Incidence of AR,lung infection,graft loss and postoperative 5-year patients and renal allograft survival rate were compared among three groups.Correlation analysis was also performed between pre-operative sCD30 level and postoperative dialysis time,AR,or lung infection.Results The average pre-transplantation sCD30 level was significantly higher than that of healthy individuals (P＜0.01 ).During the 5-year follow-up period,the incidence of AR in groups L,I and H was 17.4％ (45/259),29.2％ (77/264) and 42.9％ (27/63) respectively,and the lung infection rate was 20.8％,8.3％ and 15.9％ respectively.There was significant differences in AR incidence and lung infection rate among these three groups (P＜0.01).The pre-transplantation sCD30 level in patients with AR was (180.0± 89.1) U/ml,which was significantly higher than in those without AR (135.3 ± 72.7 U/ml,P＜0.01).The pre-transplantation sCD30 level in patients with lung infection was (123.2±75.5) U/ml,which was significantly lower than in those without lung infection (150.7 ± 79.6 U/mL,P＜0.01).The pre-transplantation sCD30 level had a positive relationship with AR (r =0.242,P＜0.01),but a negative correlation with lung infection (r=- 0.147,P＜0.01).In group H, five-year cumulative survival rate of recipients and renal grafts was 79.4％ and 69.8％ respectively,which was significantly lower than in group L (90.3％ and 87.3％),and group I (91.3％ and 87.6％) (P＜0.05,P＜0.01),but there was no significant difference between group L and group I (P＜0.01).Conclusion Pretransplant sCD30 level in renal transplant recipients is remarkably correlated with postoperative AR and lung infection,which can be considered as an independent predictor for postoperative AR,lung infection and the risk of graft function loss.
