血清可溶性细胞间粘附分子-1在肾移植术后急性排斥监测中的意义

Circulating ICAM 1 in sera of renal allograft recipients in monitoring of acute rejection

目的了解血清可溶性细胞间粘附分子１（ｃＩＣＡＭ１）在肾移植术后急性排斥监测中的意义。方法采用双抗体夹心酶联免疫法，观察８７例肾移植及发生２９例急性排斥、８例环孢素（ＣｓＡ）肾中毒患者ｃＩＣＡＭ１的变化。结果移植术后ｃＩＣＡＭ１水平短暂升高后即随移植肾功好转而下降，至术后两周达正常水平。急性排斥时ｃＩＣＡＭ１显著高于移植肾功稳定组及ＣｓＡ肾中毒组（Ｐ＜０．００１）。抗排斥治疗有效后，ｃＩＣＡＭ１又逐渐降至正常水平。结论肾移植术后动态监测ｃＩＣＡＭ１的变化，不仅可早期诊断急性排斥并观察其治疗效果，而且有助于急性排斥与ＣｓＡ肾中毒的鉴别。

Objective To study the significance of ICAM 1 in sera of renal allograft recipients in mornitoring of acute rejection. Methods The levels of circulating intercellular adhesion molecule 1 (cICAM 1) in sera of 87 renal transplantation recipients, including 29 patients with acute rejection and 8 patients with cyclosprine nephrotoxicity were measured by sandwich ELLSA. Results The levels of cICAM 1 were elevated transiently after transplantation. They decreased and reached normal levels within 2 weeks. In the acute rejection episode, the levels of cICAM 1 were significantly higher than those of patients with stable graft function and cyclosporine nephrotoxicity ( P <0.001). The increase of cICAM 1 was seen 1～3 days early than the diagnosis was made. On successful antirejection therapy, the levels of cICAM 1 decreased to normal, but in patients with steroid resistant rejection, it did not decrease. Conclusion The cICAM 1 in sera can be used to estimate the graft function, and it is also useful in prediction and differential diagnosis of acute rejection and prognosis.