肾移植患者手术前后血清IL-18、Scr、BUN动态监测的临床价值

Clinical Value of Dynamic Monitoring of Serum IL-18,Scr and BUN in Patients before and after Renal Transplantation

目的探讨肾移植患者手术前后血清IL-18、Scr、BUN动态监测的临床价值。方法选取我院2018年11月至2019年10月实施肾移植手术患者50例作为观察组,并根据是否发生急性排斥分为急性排斥组和稳定组;选择同期50例健康体检者为对照组。应用ELISA法动态监测分析术前及术后5 d、10 d、20 d血清IL-18、Scr、BUN水平。结果观察组的血清IL-18水平为(320.71±246.94)ng/L,高于对照组的(54.93±19.76)ng/L,差异有统计学意义(P<0.05)。稳定组术后5 d的IL-18水平高于术前,术后10 d、20 d的IL-18水平低于术后5 d(P均<0.05);稳定组术后10 d、20 d的Scr、BUN水平均低于术前及术后5 d(P<0.05)。与术前相比,急性排斥组术后5 d、10 d、20 d的IL-18水平升高,Scr水平下降(P<0.05)。急性排斥组术后5 d、10 d、20 d的IL-18、Scr、BUN水平均高于稳定组(P<0.05)。结论动态监测肾移植手术患者血清IL-18、Scr、BUN可作为判断急性排斥反应极佳的参考指标,具有较高的临床应用价值。

Objective To explore the clinical value of dynamic monitoring of serum IL-18,Scr and BUN in patients before and after renal transplantation.Methods 50 cases of patients with renal transplantation in our hospital from November 2018 to October 2019 were selected as observation group,and divided into acute rejection group and stable group according the acute rejection.50 people with physical examiners at the same period were selected as control group.The serum IL-18,Scr and BUN levels before operation,and 5 d,10 d and 20 d after operation were monitored by ELISA dynamically.Results The serum IL-18 level of the observation group was(320.71±246.94)ng/L,higher than(54.93±19.76)ng/L of the control group(P<0.05).In the stable group,the IL-18 level at 5 d after operation was higher than that before operation,the IL-18 levels at 10 d and 20 d after operation were lower than that at 5 d after operation,and the Scr and BUN levels at 10 d and 20 d after operation were lower than those before operation and 5 d after operation(all P<0.05).Compared with those before operation,the IL-18 levels at 5 d,10 d and 20 d after operation in the acute rejection group increased,and the Scr levels decreased(all P<0.05).The IL-18,Scr and BUN levels at 5 d,10 d and 20 d after operation in the acute rejection group were higher than those in the stable group(P<0.05).Conclusions Serum IL-18,Scr and BUN dynamic monitoring in patients with renal transplantation can be used as excellent reference indicators to judge acute rejection,which has higher clinical application value.