胆汁IL-6水平的检测对早期预测肝移植急性排斥反应的临床意义

Sequential serum and bile IL-6 levels monitoring predict allograft early rejection in liver transplantation

目的 评价胆汁 IL - 6水平在诊断肝移植急性排斥反应中的意义。方法 连续 3周监测 18例肝移植受者术后血清及胆汁 IL - 6水平 ,观察其与急性排斥反应的关系。结果 在急性排斥反应 (AR)组 ,88.9%的患者在排斥发作时胆汁 IL - 6水平明显升高 ,与非排斥组比较有显著性差异 (P<0 .0 1)。当 AR经激素冲击治疗逆转后 ,胆汁 IL - 6下降至排斥前的水平。在 AR组 ,仅有 2例受者在排斥发作时血清 IL - 6水平升高 ,与非排斥组相比 ,血清IL - 6水平无显著性差异 (P>0 .0 5 )。结论 胆汁 IL - 6水平可以作为诊断急性排斥反应敏感、较特异及非侵袭性的诊断手段 ,同时 ,其水平可作为观察抗排异治疗是否有效的指标。

Objective To evaluate the significance of interleukin 6 (IL 6) in bile for the diagnosis of acute rejection rejection after liver transplantation.Methods Eighteen patients who underwent orthotopic liver transplantation were included in this study.After liver transplantation,bile and blood were collected daily,and IL 6 levels were measured.Results Serum IL 6 levels increased only in 2 recipients when acute rejection developed.There were no significant difference in serum mean IL 6 levels between acute rejection and no rejection groups ( P > 0.05) of transplant recipients.In contrast,bile IL 6 levels increased significantly in patients with acute rejection compared with patients with no rejection.Patients who had no rejection had low levels of bile IL 6.In patients with acute rejection,bile IL 6 significantly increased ( P <0.01),but decreased in response to anti rejection therapy.Conclusions Measurement of IL 6 in bile may be a useful,noninvasive indicator for diagnosing acute rejection.