Luminex技术检测肾移植患者血清IL-17预测急性排斥反应的回顾性研究

Retrospective Study of Detection of Serum IL-17 for Predicting Early Acute Renal Allograft Rejection by Luminex Technique

目的应用Luminex液相芯片技术检测肾移植患者血清IL-17的表达水平,探讨其与移植肾早期急性排斥反应的关系。方法选取2009年1月~2011年10月期间38例肾移植患者和20例健康对照者;根据预后将肾移植患者分为急性排斥组(18例)和非排斥组(20例),分别检测两组肾移植患者及健康对照者血清IL-17的表达情况,分析血清IL-17与移植肾患者发生急性排斥反应的相关性。结果肾移植患者术前血清IL-17的平均水平为1.3±1.9 pg/ml,显著低于健康对照_组(6.9±8.5 pg/ml),差异有统计学意义(t=3.968,P<0.001);肾移植患者急性排斥组血清在术后第7天IL-17水平为3.4±5.8 pg/ml,高于非排斥组(0.5±0.4 pg/ml),差异有统计学意义(t=2.242,P=0.031)。Kaplan-Meier法生存分析显示肾移植术后非排斥反应患者血清IL-17高值水平的生存率显著低于低值水平(P<0.001)ROC曲线显示,将肾移植患者术后第4天与第7天血清IL-17水平联合分析,预测其急性排斥反应的灵敏度和特异度分别为66.67%和10.0%。结论肾移植患者术后4~7天血清IL-17水平的动态升高趋势可预测其早期急性排斥反应发生的可能性。

Objective To detect the expression of IL-17 in renal transplant recipients by Luminex and evaluate the relationship between the level of serum IL-17 and early acute renal allograft rejection. Methods 38 kidney transplant recipients and healthy controls （HC,healthy volunteers, n = 20） were selected in this study from January 2009 to October 2011. All patients were divided into two groups according to their allograft outcome as acute rejection group （ARG,n= 18） and non-re- jection group （NRG,n= 20）. The expression of serum IL-17 was detected by Luminex technique in two groups of kidney transplant recipients and HC. To evaluate the correlation between the level of serum IL 17 and early acute renal allograft re- jection. Results The mean level of IL-17 in all renal transplant recipients 1.3 ± 1.9 pg/ml at the pre-transplantation was significantly lower than that in HC （6.9 ± 8.5 pg/ml, t= 3. 968,P〈0. 001）. The results highlighted that the level of serum IL-17 in ARG 3.4±5.8 pg/ml was significantly higher than that in NRG （0.5±0.4 pg/ml） on the 7th days post Kidney transplantation （post-KTx,t= 2. 242,P= 0. 031）. Kaplan-Meier survival analysis showed that the probability of rejection- free survival in the higher levels group of IL-17 on the 7th days post-KTx was significant lower than that in the lower levels group （P〈0. 001）. The results of receiver operating characteristic curve showed that the sensitivity and specificity of the combined IL-17 to predict acute rejection were 66.67% and 100% ,respectively. Conclusion The serum IL-17 levels in renal transplant recipients on the 4th and 7th post-KTx days can predict early renal transplant rejection.