用SIL－2R监测肾移植排斥反应的探讨

DISCUSSION OF MORNITERING REJECT REACTION INCIDENCE AFTER KIDNEY-TRANSPLANATION WITH SERUM SIL-2 R LEVEL AS A SENSITIVE MARKER

用双抗夹心间接ＥＬＩＳＡ法，对２３例肾移植病人进行术前后血清中ＳＩＬ－２Ｒ（可溶性白细胞介素２受体）水平观察。其正常人ｘ值为３４８±４０．２Ｕ／ｍｌ，而肾移植病人术前ｘ为６３８±１１２．５Ｕ／ｍｌ，两者有着非常显著性差异（Ｐ＜０．００１）。通过患者ＳＩＬ－２Ｒ含量的动态追踪，可见以下规律：１．肾移植术前后ＳＩＬ－２Ｒ的含量在正常水平，提示肾移植排斥反应发生的可能性较小。２．术前ＳＩＬ－２Ｒ水平显著升高，而术后其含量持续下降，则约有１５．２％出现排斥反应。３．无论术前ＳＩＬ－２Ｒ水平高低，移植术后在同样的治疗条件下，ＳＩＬ－２Ｒ水平非但不降反而升高者，排斥反应发生的可能性最大，可达７５％。观察结果证实ＳＩＬ－２Ｒ水平可作肾移植排斥反应的监测及诊疗指标。

The serum soluble interleukin-2 receptor (SIL-2RA) levels were observed in 23 kidney-transplanated acceptors using double antibody sand with ELISA.Serum SIL -2 R Levels were also compared with each other before and after the transplantation.The results indicated that serum SIL-2 R level in the normal was 248±40.2 u/ml, but 689. 11 ±112.9 u/ml in the kidney-acceptors. Both of them was significantly different(p<0.001).We also observed the following phenomenon by regular detect of SIL-2 R Level: (1)There was a little possibility of reject reaction incidence if the serum SIL-2 RLevel was lower before transplantatlon.1(2) However, if it is obviously higher before transplantation fourthermore,and consisatantly increased after transplantation,the risk of reject reaction accidence was quite high,even up to75% of cases;(3)In the case of keeping gradually reduced ways had favourable prognosis that rate of reject accidence was less than 15% of cases. The above results showed that serum SIL-2 R level would be a good and sensitive index in monitering changes of diseases.