中华器官移植杂志
中華器官移植雜誌
중화기관이식잡지
CHINESE JOURNAL OF ORGAN TRANSPLANTATION
2015年
2期
68-72
,共5页
沈兵%刘军%李婷%唐丽洁%邱建新%于青%范昱
瀋兵%劉軍%李婷%唐麗潔%邱建新%于青%範昱
침병%류군%리정%당려길%구건신%우청%범욱
肾移植%移植肾功能恢复延迟%血管紧张素Ⅱ1型受体抗体
腎移植%移植腎功能恢複延遲%血管緊張素Ⅱ1型受體抗體
신이식%이식신공능회복연지%혈관긴장소Ⅱ1형수체항체
Kidney transplantation%Delayed graft function%Antibodies against angiotensin Ⅱ type 1 receptor
目的 评价血管紧张素Ⅱ1型受体自身抗体(AT1-AA)对移植肾功能恢复延迟(DGF)发生和发展的影响.方法 回顾性研究2010年1月至2012年12月间139例肾移植受者的临床资料,采用酶联免疫吸附法测定AT1-AA血清结合水平.根据AT1-AA水平将DGF受者分为AT1-AA高结合力组(研究组,11例)及AT1-AA低结合力组(对照组,23例),对两组受者的临床资料、实验室数据及组织学特性进行分析,观察AT1-AA对DGF的发生及转归的影响.结果 139例受者中,24例为AT1-AA阳性,115例为阴性;术后共有34例发生DGF,发生率为24.5％(34/139),其中AT1-AA阳性受者的DGF发生率为45.8％(11/24),AT1-AA阴性受者为20.0％(23/115),二者比较,差异有统计学意义(P＜0.05).此外,与对照组比较,研究组受者接受肾脏替代治疗的时间较长[(59±32)个月和(47±26)个月,P＜0.05)]、肾动脉阻力指数更高(0.80±0.10和0.72±0.10,P＜0.05)及急性肾小管损伤(2.7±0.5比1.8±1.1,P＜0.05)/急性肾小管坏死(0.9±0.5比0.5±0.3,P＜0.05)较为严重.1年随访结果显示,两组移植肾存活率无明显差异(90.9％比95.7％,P＞0.05).结论 自身高结合力AT1-AA在DGF的发生和发展过程中起重要的作用.
目的 評價血管緊張素Ⅱ1型受體自身抗體(AT1-AA)對移植腎功能恢複延遲(DGF)髮生和髮展的影響.方法 迴顧性研究2010年1月至2012年12月間139例腎移植受者的臨床資料,採用酶聯免疫吸附法測定AT1-AA血清結閤水平.根據AT1-AA水平將DGF受者分為AT1-AA高結閤力組(研究組,11例)及AT1-AA低結閤力組(對照組,23例),對兩組受者的臨床資料、實驗室數據及組織學特性進行分析,觀察AT1-AA對DGF的髮生及轉歸的影響.結果 139例受者中,24例為AT1-AA暘性,115例為陰性;術後共有34例髮生DGF,髮生率為24.5％(34/139),其中AT1-AA暘性受者的DGF髮生率為45.8％(11/24),AT1-AA陰性受者為20.0％(23/115),二者比較,差異有統計學意義(P＜0.05).此外,與對照組比較,研究組受者接受腎髒替代治療的時間較長[(59±32)箇月和(47±26)箇月,P＜0.05)]、腎動脈阻力指數更高(0.80±0.10和0.72±0.10,P＜0.05)及急性腎小管損傷(2.7±0.5比1.8±1.1,P＜0.05)/急性腎小管壞死(0.9±0.5比0.5±0.3,P＜0.05)較為嚴重.1年隨訪結果顯示,兩組移植腎存活率無明顯差異(90.9％比95.7％,P＞0.05).結論 自身高結閤力AT1-AA在DGF的髮生和髮展過程中起重要的作用.
목적 평개혈관긴장소Ⅱ1형수체자신항체(AT1-AA)대이식신공능회복연지(DGF)발생화발전적영향.방법 회고성연구2010년1월지2012년12월간139례신이식수자적림상자료,채용매련면역흡부법측정AT1-AA혈청결합수평.근거AT1-AA수평장DGF수자분위AT1-AA고결합력조(연구조,11례)급AT1-AA저결합력조(대조조,23례),대량조수자적림상자료、실험실수거급조직학특성진행분석,관찰AT1-AA대DGF적발생급전귀적영향.결과 139례수자중,24례위AT1-AA양성,115례위음성;술후공유34례발생DGF,발생솔위24.5％(34/139),기중AT1-AA양성수자적DGF발생솔위45.8％(11/24),AT1-AA음성수자위20.0％(23/115),이자비교,차이유통계학의의(P＜0.05).차외,여대조조비교,연구조수자접수신장체대치료적시간교장[(59±32)개월화(47±26)개월,P＜0.05)]、신동맥조력지수경고(0.80±0.10화0.72±0.10,P＜0.05)급급성신소관손상(2.7±0.5비1.8±1.1,P＜0.05)/급성신소관배사(0.9±0.5비0.5±0.3,P＜0.05)교위엄중.1년수방결과현시,량조이식신존활솔무명현차이(90.9％비95.7％,P＞0.05).결론 자신고결합력AT1-AA재DGF적발생화발전과정중기중요적작용.
Objective To evaluate the impact of autoantibodies to angiotensin Ⅱ type 1 receptor AT1-AA on clinic outcomes of delayed graft function (DGF) grafts.Method We reviewed the records of all 139 consecutive adult recipients who received single kidney transplantation and clinical management between Jan.2010 and Dec.2012 in our centre.The serum levels of AT1-AA were measured by a streptavidin-enzyme-linked immunosorbent assay.All patients with DGF were enrolled in this study and divided into two groups:(1) AT+ DGF group (serum AT1-AA positive,11 cases) ;(2) AT-DGF group (serum AT1-AA negative,23 cases).All clinical and laboratory data were recorded in our transplant database system at each visit.Result 139 recipients were enrolled.The overall presence of DGF was 24.5％ (34/139).The incidence of DGF in patients with high binding AT1-AA was significantly higher than that in those with low binding of AT1-AA (11/24 vs.23/115,45.8％ vs.20.0％,P＜0.05).In addition,longer duration of renal replacement therapy (59 ± 32 vs.47 ± 26 months,P＜0.05),higher resistance index (0.80 ± 0.10 vs.0.72 ± 0.10,P＜0.05) of allografts and more severe acute tubular injury (2.7 ± 0.5 vs.1.8 ± 1.1,P＜0.05)/acute tubular necrosis (0.9 ± 0.5 vs.0.5 ± 0.3,P＜0.05) were observed in AT + DGF group than in AT-DGF group.One-year graft survival and death censored graft survival were similar between two groups (90.9％ vs.95.7％,P＞0.05).Conclusion Presence of high binding anti-AT1 receptor had detrimental impacts on initiation and development of DGF.
