中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2014年
10期
590-593
,共4页
王旭珍%薛武军%田晓辉%郑瑾%田普训%丁小明
王旭珍%薛武軍%田曉輝%鄭瑾%田普訓%丁小明
왕욱진%설무군%전효휘%정근%전보훈%정소명
肾移植%急性排斥反应%sCD30
腎移植%急性排斥反應%sCD30
신이식%급성배척반응%sCD30
kidney transplant%Acute rejection%sCD30
目的 探讨血清sCD30水平在预测肾移植后急性排斥反应(AR)中的作用.方法 选取2010年12月至2012年10月接受肾移植的受者,进行6个月的随访研究.根据临床转归情况将受者分为肾功能稳定组(72例)和AR组(34例).分别于术前及术后3d、7d、14 d、21 d、28 d、2个月、3个月、4个月、5个月和6个月,以及发生AR当天和AR逆转后动态监测受者的血清sCD30水平.以20例健康成人志愿者的血清sCD30水平作为对照.结果 AR组术前血清sCD30水平为(33.42±11.49)μg/L,肾功能稳定组为(26.51±13.70)μg/L(P＞0.05).发生AR时,受者的血清sCD30水平为(50.38±12.10)μg/L,显著高于肾功能稳定组的(20.03±6.68)μg/L(P＜0.05)及对照组的(13.57±5.56)μg/L(P＜0.05).抗AR治疗结束后,受者的血清sCD30水平为(15.31±6.37)μg/L,较治疗前的(50.38±12.10)μg/L显著下降(P＜0.05).术前血清sCD30水平预测术后AR发生风险的灵敏度为91.30％,特异度为84.21％,曲线下面积为0.928,Cutoff值为24.96 μg/L.结论 肾移植后早期动态监测血清sCD30水平对AR的预警和无创诊断具有一定指导意义,可为个体化免疫抑制治疗提供依据.
目的 探討血清sCD30水平在預測腎移植後急性排斥反應(AR)中的作用.方法 選取2010年12月至2012年10月接受腎移植的受者,進行6箇月的隨訪研究.根據臨床轉歸情況將受者分為腎功能穩定組(72例)和AR組(34例).分彆于術前及術後3d、7d、14 d、21 d、28 d、2箇月、3箇月、4箇月、5箇月和6箇月,以及髮生AR噹天和AR逆轉後動態鑑測受者的血清sCD30水平.以20例健康成人誌願者的血清sCD30水平作為對照.結果 AR組術前血清sCD30水平為(33.42±11.49)μg/L,腎功能穩定組為(26.51±13.70)μg/L(P＞0.05).髮生AR時,受者的血清sCD30水平為(50.38±12.10)μg/L,顯著高于腎功能穩定組的(20.03±6.68)μg/L(P＜0.05)及對照組的(13.57±5.56)μg/L(P＜0.05).抗AR治療結束後,受者的血清sCD30水平為(15.31±6.37)μg/L,較治療前的(50.38±12.10)μg/L顯著下降(P＜0.05).術前血清sCD30水平預測術後AR髮生風險的靈敏度為91.30％,特異度為84.21％,麯線下麵積為0.928,Cutoff值為24.96 μg/L.結論 腎移植後早期動態鑑測血清sCD30水平對AR的預警和無創診斷具有一定指導意義,可為箇體化免疫抑製治療提供依據.
목적 탐토혈청sCD30수평재예측신이식후급성배척반응(AR)중적작용.방법 선취2010년12월지2012년10월접수신이식적수자,진행6개월적수방연구.근거림상전귀정황장수자분위신공능은정조(72례)화AR조(34례).분별우술전급술후3d、7d、14 d、21 d、28 d、2개월、3개월、4개월、5개월화6개월,이급발생AR당천화AR역전후동태감측수자적혈청sCD30수평.이20례건강성인지원자적혈청sCD30수평작위대조.결과 AR조술전혈청sCD30수평위(33.42±11.49)μg/L,신공능은정조위(26.51±13.70)μg/L(P＞0.05).발생AR시,수자적혈청sCD30수평위(50.38±12.10)μg/L,현저고우신공능은정조적(20.03±6.68)μg/L(P＜0.05)급대조조적(13.57±5.56)μg/L(P＜0.05).항AR치료결속후,수자적혈청sCD30수평위(15.31±6.37)μg/L,교치료전적(50.38±12.10)μg/L현저하강(P＜0.05).술전혈청sCD30수평예측술후AR발생풍험적령민도위91.30％,특이도위84.21％,곡선하면적위0.928,Cutoff치위24.96 μg/L.결론 신이식후조기동태감측혈청sCD30수평대AR적예경화무창진단구유일정지도의의,가위개체화면역억제치료제공의거.
Objective To explore the significance of serum CD30 in predicting acute rejection in kidney transplant recipients.Method A total of 106 kidney transplant recipients were recruited in this prospective six months follow-up study from December 2010 to October 2012.According to the clinical outcome,the subjects were devided into stable renal function group (72 cases) and acute rejection group (34 cases).Twenty healthy subjects were choosed as controls.Serum sCD30 levels were detected by ELISA.The whole peripheral blood samples were collected from all recipients before transplantation,at days 7,14,21 and 28 post-transplantation,and at months 2,3,4,5 and 6 posttransplantation.Additional blood samples were collected for on the days that acute rejection occurred and reversed.Result Preoperative serum sCD30 levels were 33.42 ± 11.49 and 26.5 1 ± 13.70μg/L in AR group and stable group respectively.When acute rejection occurred,serum sCD30 levels in AR group was 50.38 ± 12.10μg/L,which was significantly higher than stable group (20.03 ± 6.68μg/L,P＜0.05) and healthy control group (13.57 ± 5.56 ng/L,P＜0.05).After the anti-rejection therapy,serum sCD30 levels decreased to 15.31 ± 6.37μg/L,which was lower than that before the therapy started (50.38± 12.10 μg/L,P＜0.05).Elevated preoperative serum sCD30 levels suggested a higher risk of acute rejection in kidney transplant recipients,with Cutoff values of 24.96 μg/L,and the sensitivity and specificity were 91.30％ and 84.21％ respectively.Conclusion Serum sCD30 levels can predict and assess the risks of rejection episodes in kidney transplant recipients.
