摘要
目的:分析外周血循环内皮细胞(CECs)与移植肾急性排斥反应(AR)的关系及对预后判断的意义。方法:2006年11月至2007年12月在我院行移植肾活检患者42例。依肾活检病理改变,将患者分为移植肾正常改变组(组I)和AR组(组II),组II再分为急性血管性排斥组(组II-A)、急性混合性排斥组(组II-B)和急性间质小管性排斥组(组II-C)。患者在移植肾活检前2d抽外周血,采用免疫磁珠分离方法检测CECs并计数。结果:组II(n=25)CECs计数高于组I(n=17)(27.0±13.6vs14.6±4.2,P<0.01)。组II-A(n=5)CECs计数高于组II-C组(n=13)(38.6±6.8vs19.5±9.5,P<0.01),组II-B(n=7)CECs计数高于组II-C(32.6±15.9vs19.5±9.5,P<0.01),而组II-A和组II-B之间CECs计数差异无统计学意义(P>0.05);组II-C的CECs计数虽然高于组I,但两者之间差异无统计学意义(P>0.05)。CECs计数升高(CECs≥24 cells/ml)组动脉内膜炎发生率较高(P<0.01)。组II中CECs升高者耐激素比例高(P<0.05),1年后移植肾存活率低(P<0.01)。II-A组经治疗后CECs计数随着移植肾功能改善下降(P<0.01)。结论:肾移植受者CECs计数可作为判断排斥反应中血管病变及治疗反应的重要指标。
Objective : To investigate the value of peripheral blood circulating endothelial cells (CECs) on the diagnosis and the short-term outcome of acute rejection (AR) in patients with renal allograft. Methodology:Total fourty two renal transplant patients received renal allograft biopsy from Nov. 2006 to Dec. 2007 were investigated in this study. They were divided into two groups: group Ⅰ (normal group,n = 17) and group Ⅱ (AR group, n =25). Then the group Ⅱ was separated into group Ⅱ-A ( acute vascular rejection group, n = 5 ), group Ⅱ-B ( mixed rejection group, n = 7 ) and group II-C (acute tubulointerstitial rejection group,n = 13 ). The CECs were isolated from peripheral blood and were counted by microscopy during the renal biopsy time. Results:The count of CECs was higher in group Ⅱ than that in group Ⅰ (27.0 ± 13.6 vs ld. 6 ± 4. 20, P 〈 0. 01 ), in group Ⅱ-A higher than that in group II-C ( 32.6 ± 15.9 vs 19. 5 ± 9. 50, P 〈 0. 01 ) and no significant difference between group Ⅱ-A and group Ⅱ-B ( P 〉 0. 05 ). The count of CECs in group Ⅱ-C was higher than group Ⅰ with no significant difference ( P 〉 0. 05 ). The increasing count of CECs ( CECs t〉 24 cells/ml ) was related to endarteritis (P 〈 0. 01 ). The steroid resistant rate of high CECs count was higher than that of low CECs count( CECs 〈 24 cells/ml)in group Ⅱ (9/14 vs 3/11 ,P 〈0. 05). The one year graft survival of patients with high CECs count was worse than that with low CECs count (P 〈 0. 05). The count of CECs was decreased significantly with the recovery of renal allograft function in group Ⅱ-A (P 〈 0.01 ). Conclusion:The count of CECs in peripheral blood was related to the AR, and also related to the endarteritis in renal allograft. It might be used as a differential diagnosis marker for the AR and a marker for the prognosis of AR.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
北大核心
2010年第3期230-235,共6页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
肾移植
循环内皮细胞
急性血管性排斥反应
动脉内膜炎
预后
circnlating endothelial cells kidney transplantation acute rejection endarteritis short-term outcome