肾移植患者血清血管形成素水平检测及其临床意义

Serum angiogenin concentration in renal transplantation recipients and its clinical significance

目的 观察肾移植患者在手术前后血清血管形成素 (angiogenin ,ANG)水平的动态变化并分析其可能的临床意义。方法 2 4例行肾移植手术的患者为肾移植组 ,2 6例健康志愿者为正常组 ,取二者的血清 ,其中肾移植组分术前 1天、术后 1天、1周、2周、3周、4周和 2个月各取血 1次 ,运用ELISA法检测血清ANG浓度 ,全自动生化分析仪测定血清肌酐 (Cr)和尿素氮 (BUN)浓度。结果 术前肾移植组血清ANG浓度 (317 6± 89 7)ng/ml与正常组 (2 92 7± 73 5 )ng/ml比较差异无显著性 (P >0 0 5 ) ,术后 1天即开始升高 (36 9 8± 10 3 2 )ng/ml,P <0 0 5。术后 3周为最高 (5 0 4 8± 15 3 1)ng/ml,P <0 0 0 1。其后开始回落 ,2个月左右降至正常组 (P >0 0 5 )和术前 (P >0 0 5 )水平 (315 3± 92 8)ng/ml。术后患者血清Cr和BUN浓度均有明显降低 ,但与升高的血清ANG水平无关 (P >0 0 5 )。结论 肾移植患者血清ANG水平在术后迅速升高 ,持续约 2个月。这可能是一种保护性修复机制 ,有助于血管吻合、抗感染和切口愈合 。

Objective To study the change of serum angiogenin (ANG)concentration in renal transplantation recipients and its clinical significance. Methods Serum ANG concentration was measured by ELISA. Sera were obtained from 24 renal transplantation recipients preoperatively and postoperatively(renal transplantation group, RT group) and from 26 healthy volunteers(the normal group). Postoperative serum samples were obtained 1 day, 1, 2, 3 and 4 weeks and 2 months after surgery, respectively. Serum creatinine(Cr) and blood urea nitrogen(BUN) concentrations were determined with an automatic biochemical analyzer. Results Before surgery, the mean serum ANG concentration of the RT group(317.6±89.7)ng/ml was not significantly different from that of the normal group(292.7±73.5)ng/ml, P>0.05. On the day after surgery, the mean serum ANG concentration began to rise(369.8±103.2)ng/ml, P<0.05, reached the peak in 3 the third week(504.8±153.1)ng/ml, P<0.001, and returned to normal level(P>0.05) or preoperative level(P>0.05) after 2 months(315.3±92.8)ng/ml. In RT group, the serum Cr and BUN concentrations decreased significantly after surgery compared to preoperative values, but had no correlation with the increased serum ANG concentration(P>0.05). Conclusion The results suggest that the increased postoperative concentration of serum ANG for 2 months in renal transplantation recipients might be a protective repair mechanism, contributing to vascular anastomosis, antimicrobial response and incision healing, although it is not a definite prognostic factor.