肾移植术后血清IL-6水平的动态监测及临床意义

Evaluation of sequential monitoring of IL-6 of renal allograft recipients

目的 :观察肾移植术后发生急性排斥反应、感染、Cs A中毒时血清 IL- 6的变化 ,以探讨 IL- 6在急性排斥反应的早期诊断、鉴别诊断中的意义。方法 :采用双抗体夹心酶联免疫吸附法 ,对 10 6例肾移植患者血清 IL-6活性水平于肾移植手术前后进行动态监测。结果 :肾移植术前 ,IL- 6与对照组比较差别无显著性意义 ,术后第 1天明显升高 ,2周左右基本降至术前水平。发生急性排斥反应前 1～ 3天 ,血清 IL - 6即有升高 ,峰值出现在抗排斥反应治疗的当天 ,经甲基泼尼松尼 (MP)冲击有效后迅速下降 ,治疗无效者 ,血清 IL - 6持续在高水平。并发感染时 ,IL - 6也显著升高 ,与急性排斥反应组相比差别无显著性意义 ;而 Cs A中毒时 ,IL - 6变化不明显。结论 :动态监测 IL- 6可以作为急性排斥反应的早期诊断。

Purpose:To study IL 6 in renal allograft recipients with infection, acute rejection and CsA induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Method:The sequential monitoring of IL 6 were conducted by ELISA technique in 106 patients before and after renal transplantation.Result:The levels of IL 6 increased in the first day posttransplantation, decreased and stabilized after 2 weeks, increased 1 to 3 days prior to the clinical diagnosis in acute rejection, increased in infection and had no significant difference in CsA induced nephrotoxicity.Conclusion:It suggests that the sequential monitoring of serum IL 6 of renal allograft recipients can be used to estimate the function of graft, as markers of the early diagnosis and differential diagnosis of acute rejection.