动态监测血清sCD30在肾移植后急性排斥反应预警中的意义  

Dynamic monitoring serum CD30 in predicting acute rejection in kidney transplant recipients

作　　者：王旭珍[1] 薛武军[1] 田晓辉[1] 郑瑾[1] 田普训[1] 丁小明[1] 

机构地区：[1]西安交通大学医学院第一附属医院肾脏病医院肾移植科,710061

出　　处：《中华器官移植杂志》2014年第10期590-593,共4页Chinese Journal of Organ Transplantation

摘　　要：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、14d、21d、28d、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）#g／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24．96μg／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。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 post- transplantation. 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. 51±13. 70 μg/L in AIR group and stable group respectively. When acute rejection occurred, serum sCD30 levels in AR group was 50.38 ± 12. 10 μg/L,which was significantly higher than stable group （20.03 ± 6.68 μg/L, P〈0. 05） and healthy control group （13.57 ± 5.56 μg/L,P〈0. 05）. After the anti-rejection therapy, serum sCD30 levels decreased to 15.31 ± 6. 37 μg/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. 96μg/L, and the sensitivity and specificity were 91.30% and 84. 21% respeetively. Conelusion Serum sCD30 levels can predict and assess the risks of rejection episodes in kidney transplant recipients.

关 键 词：肾移植 急性排斥反应 SCD30 

分 类 号：R699.2[医药卫生—泌尿科学]