尿液中IP-10、Mig和OPG含量与移植肾排斥反应相关性的临床研究  

The clinical study of correlation between contents of Urine IP-IO, Mig, OPG and the occurrence acute rejection of renal transplantation

作　　者：陆瀚澜[1] 张鑫[1] 陈瑜[1] 郑鳕洋[1] 傅尚希[1] 张雷[1] 周梅生[1] 曾力[1] 朱有华[1] 王立明[1] 

机构地区：[1]第二军医大学长征医院器官移植科,上海200003

出　　处：《中华器官移植杂志》2012年第11期672-675,共4页Chinese Journal of Organ Transplantation

基　　金：基金项目：上海市科委基础研究重点项目（11JC1416100）

摘　　要：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Luminex2000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的水平厦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．IPL10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。As a retrospective nested case-control study, biopsy confirmed acute rejection reaction by 20cases 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. Resglts The regjection group＇s urinary IP-10 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 group was not statistically significant. Rejection group in the rejection period urinary IP-10 and Mig levels weresignificantly non-exclusion period, the difference was statistically significant （P〈0. 01 ） higher th^n 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 the exclusion of the before and after OPG differences no statistically significant. Conclusion The and Mig content in the urine is associated with acute renal allograft rejection, which is an early reflect of ubclinical tubular injury. And its changes as early as elevated serum creatinine, is expected to become dent indicators to predict acute rejectionreaction occurs.

关 键 词：肾移植 急性排斥反应 尿液 细胞因子 

分 类 号：R699.2[医药卫生—泌尿科学]