肾移植受者肿瘤坏死因子的测定及其临床意义

TNF in renal graft recipients

动态观察４４例肾移植患者２８４例次血浆肿瘤坏死因子（ＴＮＦ）水平的变化，以探讨其在移植肾排斥反应诊断中的意义。结果表明：术后肾功能稳定组ＴＮＦ（４２．６８±１６．３７ｋＵ／Ｌ）与正常组（３９．５０±１３．５０ｋＵ／Ｌ）和尿毒症组（４０．０４±２７．５０ｋＵ／Ｌ）比较无明显差异，ＣｓＡ肾中毒组及ＡＴＮ组虽有轻度升高，但无统计学意义。排斥组ＴＮＦ（７２．４２±２４．１２ｋＵ／Ｌ）明显升高，并且可早于血肌酐升高１～３天，与前几组比较均有显著性差异，应用ＯＫＴ３／ＡＴＧ时，ＴＮＦ升高更明显。

Plasma TNF level was assayed for 284 blood samples from 44 patients with renal allograft.There was no significant difference in plasma TNF among healthy controls, patients with uremia, with functionally stable renal graft, with cyclosporin nephrotoxicity and those with acute tubular necrosis of the graft. During rejection episodes, however, there was obvious elevation of the plasma TNF as early as 1～3 days before the rise of serum creatinine. It was concluded that serial assay of plasma TNF would be helpful in the early diagnosis and differential diagnosis of acute rejection of the transplanted kidney.