CAJ | 학술논문

目的探讨肾移植受者的尿液中人干扰素诱导蛋白10(IP-10)、γ干扰素诱导单核细胞因子(Mig)和破骨细胞抑制因子(OPG)含量与移植肾排斥反应的相关性.方法采用回顾性巢式病例对照研究,以活检证实发生急性排斥反应的受者20例为排斥组,另选肾移植后肾功能恢复良好的受者20例为对照组,于术后第1天起,连续30d留取晨尿,利用Luminex 2000检验操作平台,通过PlexMark三联肾损伤标志物试剂盒检测两组受者移植后30d内每天的尿液中IP-10、Mig和OPG的水平.结果排斥组的尿IP-10为(394.7±67.3) ng/L,明显高于对照组的(10.9±3.8) ng/L(P＜0.05).排斥组的尿Mig水平为(443.0±88.9) ng/L,对照组仅为(15.7±6.99) ng/L,排斥组明显高于对照组(P＜0.05).而尿OPG的峰值水平,两组间的差异无统计学意义.排斥组在排斥时间段尿IP-10和Mig的水平显著高于非排斥时间段,差异有统计学意义(P＜0.01),其水平在不同时刻均与血肌酐浓度呈现明显的相关性,IP-10与血肌酐的相关系数(R2)=0.8673,P＜0.01,Mig与血肌酐的R2=0.7951,P＜0.01,IP-10和Mig的变化时间早于血肌酐,而排斥前后OPG的差异无统计学意义.结论尿液中IP-10和Mig含量的升高与移植肾急性排斥反应相关,可早期反映亚临床肾小管损伤,且其变化早于血肌酐的升高,有望成为独立指标来预测急性排斥反应的发生.
목적 탐토신이식수자적뇨액중인간우소유도단백10(IP-10)、γ간우소유도단핵세포인자(Mig)화파골세포억제인자(OPG)함량여이식신배척반응적상관성.방법 채용회고성소식병례대조연구,이활검증실발생급성배척반응적수자20례위배척조,령선신이식후신공능회복량호적수자20례위대조조,우술후제1천기,련속30d류취신뇨,이용Luminex 2000검험조작평태,통과PlexMark삼련신손상표지물시제합검측량조수자이식후30d내매천적뇨액중IP-10、Mig화OPG적수평.결과 배척조적뇨IP-10위(394.7±67.3) ng/L,명현고우대조조적(10.9±3.8) ng/L(P＜0.05).배척조적뇨Mig수평위(443.0±88.9) ng/L,대조조부위(15.7±6.99) ng/L,배척조명현고우대조조(P＜0.05).이뇨OPG적봉치수평,량조간적차이무통계학의의.배척조재배척시간단뇨IP-10화Mig적수평현저고우비배척시간단,차이유통계학의의(P＜0.01),기수평재불동시각균여혈기항농도정현명현적상관성,IP-10여혈기항적상관계수(R2)=0.8673,P＜0.01,Mig여혈기항적R2=0.7951,P＜0.01,IP-10화Mig적변화시간조우혈기항,이배척전후OPG적차이무통계학의의.결론 뇨액중IP-10화Mig함량적승고여이식신급성배척반응상관,가조기반영아림상신소관손상,차기변화조우혈기항적승고,유망성위독립지표래예측급성배척반응적발생.
Objective To investigate the correlation between urine levels of IP-10,Mig,OPG and the occurrence of renal allograft rejection.Methods As a retrospective nested case-control study,biopsy confirmed acute rejection reaction by 20 cases was rejection group,and recovery of renal function in kidney transplant after the elect good by 20 cases was control group.morning urine was tested of IP-10,Mig and OPG level of the two groups within 30 d after transplantation.The advantage was taken of the Luminex 2000 test platform,through PlexMark triple kidney injury marker kit to detect the daily urine of recipients.Results The rejection group's urinary IP10 wa (394.7 ± 67.3)ng/L,significantly higher than that in the control group of (10.9 ± 3.8) ng/L (P＜0,05).Urine Mig level of rejection group was (443.0 ± 88.9) ng/L,and the control group was only (15.7 ± 6.99)ng/L.Rejection group was significantly higher than that in the control group (P＜0.05).Urine OPG peak levels,the difference between the two groups was not statistically significant.Rejection group in the rejection period urinary IP-10 and Mig levels were significantly non-exclusion period,the difference was statistically significant (P＜0.01) higher than its level at different times with serum creatinine concentration showed obvious correlation,IP-10 with serum creatinine of correlation coefficients (R2)=0.8673,P＜0.01,Mig and serum creatinine R2 =0.7951,P＜0.01,IP-10 and Mig change time earlier than serum creatinine,to the exclusion of the before and after OPG differences no statistically significant.Conclusion The increasing of IP-1O and Mig content in the urine is associated with acute renal allograft rejection,which is an early reflect of subclinical tubular injury.And its changes as early as elevated serum creatinine,is expected to become independent indicators to predict acute rejection reaction occurs.