肾移植受者术前血清可溶性CD30水平与受者及移植物长期存活的关系  

Influence of pre-transplant serum level of soluble CD30 on the long-term survival rates of kidney transplant recipients and grafts

作　　者：陈江华[1] 吕蓉[1] 陈莹[1] 吴建永[1] 何强[1] 黄洪锋[1] 瞿立辉[1] 

机构地区：[1]浙江大学医学院附属第一医院肾脏病中心,杭州310003

出　　处：《中华医学杂志》2005年第22期1560-1563,共4页National Medical Journal of China

摘　　要：目的研究术前血清可溶性CD30(sCD30)水平与肾移植受者及移植物长期存活的关系。方法共纳入自1998年12月至2003年8月行同种异体肾移植手术且存有术前血标本的707例受者。回顾性总结该组受者术后长期存活及其他基线资料,用sCD30酶联免疫吸附试验(ELISA)试剂盒复孔检测肾移植受者术前血清sCD30水平。结果低、中、高sCD30组的5年肾存活率分别为84.7%±2.1%、88.1%±2.9%和77.7%±3.5%,5年功能性存活率为98.9%±1.1%,95.1%±1.6%和85.0%±3.2%。高sCD30组的移植肾的长期存活/功能性存活均明显低于低、中sCD30组(均P<0.05),但中sCD30组的人长期存活率最高,低、中、高sCD30组的5年人存活率分别为84.7%±3.9%,92.4%±1.6%和87.1%±2.7%。死亡原因均主要为感染、肝功能衰竭和心脑血管意外,但3组在死亡前1个月内发生急性排斥反应分别占死亡人数的0、13.0%和40.9%。结论术前sCD30水平与肾移植受者的免疫状态有关,高sCD30代表受者高免疫反应性,预示术后急性排斥反应的发生率增高而导致移植肾预后不良;而低sCD30表示机体相对的免疫功能低下而处于感染和药物毒性的高风险中。Objective To investigate the influence of pre-transplant sCD30 level on the long-term survival rates of kidney transplant recipients and grafts among Chinese. Methods A retrospective cohort of 707 patients undergoing cadaver renal transplants between Dec.1998 and Aug 2003, 467 males and 240 females, aged 40±11, with their blood samples preserved was studied. The plasma levels of sCD30 were determined by ELISA.Results The 5-year graft survival/functional rates of the high sCD30 group were 77.7%±3.5%/85.0%±3.2%, significantly lower than those of the low and intermediate groups, 84.7%±2.1%/ 98.9%±1.1% and 88.1%±2.9%/95.1%±1.6% respectively(all P<0.05). The 5-year recipient survival rate of the intermediate sCD30 group was 92.4%±1.6%, higher than those of the low and high sCD30 groups, 84.7%±3.9% and 87.1%±2.7% respectively with a significant difference between the intermediate and high sCD30 groups (P=0.032). Conclusions Pre-transplant serum level of sCD30 reflects the immune status. Recipients with high sCD30 are prone to rejection while those with low sCD30 are prone to infections.

关 键 词：肾移植受者 血清可溶性CD30 移植物 酶联免疫吸附试验(ELISA) 术前 水平 SCD30 同种异体肾移植手术 急性排斥反应 2003年8月 心脑血管意外 免疫功能低下 1998年 长期存活率 肝功能衰竭 免疫反应性 肾存活率 死亡原因 死亡人数 

分 类 号：R699.2[医药卫生—泌尿科学] R581.1[医药卫生—外科学]