尿转化生长因子β_1与移植肾远期功能

Urine transforming growth factor-β_1 and the function of the allografted kidney

目的探讨肾移植受者尿转化生长因子β1(TGFβ1)与远期肾功能的关系。方法对术后满1年、移植肾功能正常的患者进行3年以上的前瞻性观察,观察期内至少每6个月检测1次血和尿的Cr、TGFβ1,对肾功不全者明确是否为慢性移植物肾病(CAN)。3年后共有124例患者完成了全程随访,将其肾功能与3年前的尿TGFβ1浓度作相关性分析;将其中14例诊断为CAN的患者,比较其在肾移植1年时的血、尿TGFβ1等与其他非CAN患者有无差异。结果患者尿TGFβ1浓度与3年后的Cr之间有明显的相关性(r=0.447,P<0.01);CAN与非CAN患者在肾移植1年时,尿TGFβ1相对浓度分别为(183.2±40.7)pg/mg和(278.0±32.9)pg/mg.Cr(P<0.01);血TGFβ1浓度分别为(31.4±4.7)ng/ml和(31.1±4.9)ng/ml(P>0.05)。结论TGFβ1可能在CAN的发生过程中起着重要的作用,CAN患者在肾功能异常前尿TGFβ1已显著升高,肾移植后早期检测尿TGFβ1对远期肾功能具有预测作用。

Objective To investigate the relationship between urine transforming grouwth factor-β_1(TGF-β_1)concentration and chronic allograft nephropathy(CAN).Methods One year after kidney transplantation, the recipients with normal renal function were followed up for three years.Their blood and urine TGF-β_1 concentrations were tested at an interval of at least 6 months in 124 cases.Correlation between their renal functions(creatinine clearance rates)and their urine TGF-β_1 relative concentrations after 1 year of renal transplantation was determined.14 renal recipients were diagnosised as CAN.Their blood and urine TGF-β_1 concentrations and other factors after 1 year of renal transplantation were compared with the normal renal recipients who had no CAN.Results There was a positive correlation between long-term renal functions and urine TGF-β_1 relative concentrations after 1 year of renal transplantation(r=0.447,P<0.01).One year after renal transplantation,urine TGF-β_1 concentrations of CAN and no-CAN recipients were(183.2±40.7) pg/mg and (278.0±32.9) pg/mg.Cr respectively.The blood TGF-β_1 concentrations of CAN and no-CAN recipients were(31.4±4.7)ng/ml and (31.1±4.9) ng/ml respectively.Conclusion The urine TGF-β_1 is significantly increased before renal dysfunction in patients with CAN.The level of urine TGF-β_1 in early stage after renal transplantation can predict long-term renal function.