肾移植患者肿瘤坏死因子-α动态检测的临床意义  

Clinical Significance of Dynamic Measuirements of Serum and Urinary TNF-α Contents in Patients Receiving Kidney Trasplantation

作　　者：武翠华[1] 徐军[1] 张道杰[1] 

机构地区：[1]济南军区总院实验诊断科,250031

出　　处：《放射免疫学杂志》2004年第3期191-193,共3页Journal of Radioimmanology

摘　　要：目的 :动态观察肾移植患者肿瘤坏死因子 -α(TNF -α)水平的变化 ,探讨TNF -α对肾移植预后的意义。方法 :采用放射免疫分析检测 4 5例肾移植患者术前及术后两天血清及尿液中TNF -α的水平 ,并与 4 5例正常对照者进行对比分析。对 33例术后稳定者 ,动态检测术后 2d、7d、14d、2 1d及 2 8d血清及尿液中TNF -α的水平。结果 :术前组、术后稳定组、术后排斥组、CsA中毒组血清TNF -α水平均显著高于正常对照组 (P <0 0 1) ,术后排斥组显著高于术前组及术后其他各组 (P <0 0 1) ;术前组和术后稳定组尿液TNF -α水平均显著高于正常对照组 (P <0 0 1) ,术后排斥组尿液TNF -α水平高于正常对照组 (P <0 0 5 ) ,术后两天排斥组与稳定组间尿液TNF -α水平无显著性差异 (P >0 0 5 )。 33例肾移植术后稳定者血清TNF -α水平术后 7天开始下降 ,至 2 1天时已降至与正常对照组无显著性差异 (P >0 0 5 ) ;尿液TNF -α水平下降较血清快 ,术后 7天即降至与正常对照组无显著性差异 (P >0 0 5 )。结论 :动态检测TNF -α水平可作为观察肾移植患者排斥反应的一项重要指标。Objective To investigate the clinical significance of dynamic measurements of serum and urinary TNF-α contents in patients following kidney transplantation. Methods Serum and urinary TNF-α contents were measured with RIA in 45 patients receiving kidney transplantation (both before and 2 days after operation) and 45 controls. In the group of 33 patients without rejection, serial dynmaic measurements of serum and urinary TNF-α contents were repeatedly pertormed on d7, d14, d21 and d28 postoperatively. Results Serum TNF-α levels in all the patients groups were significantly higher than those in the controls (P<0.01), with the highest values in the patients with rejection post-operatively (vs all others, P<0.01). Urinary TNF-α levels in pre-operative patients and patients without rejection post-operatively were significantly higher than those in the controls (P<0.01). In patients with rejection, the urinary TNF-α levels were also higher than those in the controls (P<0.05), but there were no sighificant differences between the urinary levels in patients with and without rejection on d2 postoperatively. Serial dynamic determinations showed that serum TNF-α levels began to drop from d7 and were not significantly different from those in the controls on d21 (P>0.05). Urinary TNF-α levels dropped even faster and approached control values by d7. Conclusion Contions monitoring of post-operative serum and urinary TNF-α contents serves as an important indicator of the function of the transplanted kidney.

关 键 词：肾移植 肿瘤坏死因子-Α 动态检测 TNF-Α 放射免疫 

分 类 号：R699.2[医药卫生—泌尿科学]