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目的:探讨血清可溶性血管细胞粘附分子-1(sVCAM-1)测定在肾移植术后免疫学监测中的价值。方法:采用酶联免疫吸附法(ELISA)动态监测56例肾移植患者术后sVCAM-1水平的变化。结果:肾移植患者术后sVCAM-1水平呈规律性变化,急性排斥反应组sVCAM-1水平明显高于移植肾功能稳定组和CsA肾中毒组,差异有非常显著意义(P<0.01)。对激素治疗敏感的排斥反应患者,sVCAM-1逐渐降至正常水平;耐激素的排斥反应患者应用ATG治疗后,sVCAM-1在排斥反应后1个月内仍维持在较高水平。CsA肾中毒组sVCAM-1水平无明显变化。结论:肾移植术后动态监测sVCAM-1水平的变化,有助于急性排斥反应的诊断、鉴别诊断及指导临床治疗。sVCAM-1可以作为肾移植术后急性排斥反应的免疫学监测指标
Objective: To investigate the value of serum soluble vascular cell adhesion molecule-1 (sVCAM-1) in immunological surveillance after renal transplantation. Methods: The levels of sVCAM-1 in 56 renal transplant recipients were dynamically monitored by enzyme linked immunosorbent assay (ELISA). Results: The level of sVCAM-1 in renal transplant recipients changed regularly. The level of sVCAM-1 in acute rejection group was significantly higher than that in stable renal transplant recipients and CsA nephrotoxic groups. The difference was significant (P <0.01). SVCAM-1 gradually decreased to normal level in hormone-responsive rejection patients; sVCAM-1 remained high at 1 month after rejection in patients with hormone-refractory rejection after ATG treatment. CsA nephrotoxicity group sVCAM-1 levels did not change significantly. Conclusion: The dynamic changes of sVCAM-1 level after renal transplantation are helpful to the diagnosis, differential diagnosis and clinical treatment of acute rejection. sVCAM-1 can be used as an immunological indicator of acute rejection after renal transplantation