肾移植术后可溶性白细胞介素-2受体的动态监测及临床意义

Evaluation of sequential monitoring of sIL-2R of renal allograft recipients

目的 :观察肾移植术后急性排斥反应、感染、CsA中毒时血清可溶性白细胞介素 2受体 (sIL - 2R)变化 ,以探讨其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sIL - 2R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sIL - 2R与对照组差别显著 ,术后 1周内下降明显 ,2周～ 3周后有所回升并趋于稳定。发生急性排斥反应前 1d～ 3d血清sIL - 2R即有升高 ,经MP、OKT3冲击有效后迅速下降。并发感染时sIL -2R显著升高 ,CsA中毒时sIL - 2R变化不明显。结论 :动态监测sIL - 2R可以作为急性排斥反应的早期诊断、鉴别诊断的免疫生物学指标。

Objective To study sIL-2R in renal allograft recipients with acute rejection,infection and CsA-induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Method The sequential monitoring of sIL-2R was conducted by ELISA technique in 106 patients before and after renal transplantation.Results The levels of sIL-2R decreased in the first week posttransplantation,stabilized after 2 weeks and 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 sIL-2R 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.