血清抗中性粒细胞胞浆抗体滴度检测对移植肾急性血管排斥的诊断价值

The Diagnotic value of the determination of the titers of ANCA in acute vasculitis rejection following kidney transplantation

动态观察了４例移植肾急性血管排斥患者经甲基泼尼松龙和环磷酰胺双冲击治疗前后血清抗中性粒细胞胞浆抗体（ＡＮＣＡ）滴度的动态变化，分析患者治疗前后临床实验室检查和肾组织病理变化。结果：（１）病情处于急性排斥期，血清ＡＮＣＡ滴度升高；（２）治疗后，临床症状减轻，肾功能改善，肾组织病理趋于正常时，ＡＮＣＡ滴度降低；（３）随访半年，移植肾排斥缓解，４例患者血清抗髓过氧化物酶抗体（ＭＰＯ－ＡＮＣＡ）均转为阴性，２例荧光法ＡＮＣＡ（ＩＦ－ＡＮＣＡ）转为阴性。结果表明，血清ＡＮＣＡ滴度的动态变化可以作为监测移植肾急性血管排斥的一项指标。

The clinical and pathological changes in 4 patients with acute vasculitis rejection following kidney transplantation were analyzed. The titers of MPO ANCA and IF ANCA in the 4 patients were determined after the pulse remedy of methyprednisolone and cyclophosphamide. The results showed that the titer of ANCA was increased in acute rejection. After treatment, clinical symptoms were alleviated, renal function improved, pathological changes returned to normal, and the titer of ANCA decreased. After half year follow up, it was found that the rejection of the renal graft was alleviated, MPO ANCA and IF ANCA were negative in 4 cases and 2 cases respectively. In conclusion, there might exist a close correlation between sera ANCA titer and acute vasculitis rejection