肾移植受者血清C-反应蛋白动态变化及意义

Dynamic change and clinical significance of serum C-reactive protein of renal transplant recipients

目的 观察肾移植受者血清 C-反应蛋白 (C- reactive protein,CRP)的动态变化 ,探讨 CRP与急性排斥的关系。方法 以透射比浊法检测 6 0例肾移植受者术前和术后不同时间血清中 CRP浓度 ,并同时检测尿素氮 (Bun)、肌酐 (creatine,Cr)的水平 ,以 5 0例健康献血者作对照。结果 肾移植受者术前 CRP水平 (2 .5 9± 0 .5 5 ) m g/L 与正常对照组 (2 .18± 0 .5 7)mg/L 相比 ,差异无显著性 (P>0 .0 5 ) ,而术后 1d CRP明显升高至 (2 0 .2 1± 4 .87) mg/L,并于第 2天达峰值 (2 9.30± 6 .4 4 )mg/L,第 4天开始下降 ,至第 8天恢复至接近术前水平 (8.0 2± 1.30 ) m g/L,CRP的总体变化趋势与肾功能改善基本一致 ,发生急性排斥者的 CRP均有一个明显上升过程 ,应用免疫抑制剂冲击治疗后大部分迅速下降。结论 血清

Objective\ To investigate the clinical value of serum C reactive protein(CRP) levels for monitoring acute rejection in kidney allograft recipients.Methods\ At pretransplantation and different times of posttransplantation,serum CRP were measured by transmission nephelometer in 60 cases.Serum urea nitrogen(Bun) and creatine (Cr) were measured simultaneously.Fifty normal blood donors were served as controls.Results\ No significant differences were found in serum CRP levels(mg/L) between recipients(2 59±0 55) and controls (2 18±0 57) at preoperation ( P >0 05).However,the concentration of CRP rose to (20 21±4 87) mg/L obviously at the lst day after postoperation,reached peak value (29 30±6 44) mg/L at the 2nd day,began to fall at the 4th day,recovered to near normal level (8 02±1 30) mg/L at the 8th day.The gross trend of serum CRP was in accord with the improvement of kidney function.The level of CRP rose obviously in all patients with acute rejection and most of them fell down rapidly after immunosuppressive therapy.Conclusion The results suggest that the change of serum CRP concentration in renal transplant recipients is associated with the occurrence of acute rejection and the effect of immunosuppressive therapy.