血清IL-10和TNF-α水平的动态检测在早期预测肝移植术后急性排斥反应中的作用

Study on the role of serum TNF-α and IL-10 levels for prediction of early acute rejection after liver transplantation

目的 探讨肝移植术后血清IL 1 0和TNF α水平在预测急性排斥反应中的作用。方法 以 2 0 0 2年 6月～ 2 0 0 3年 4月在本院行肝移植术的 4 1例病人为研究对象 ,采用ELISA方法检测术前及术后 1周内血清IL 1 0和TNF α的水平 ,动态观察其变化规律。结果 肝移植术后血清IL 1 0和TNF α浓度较术前明显升高 ,但急性排斥反应组升高更加显著 ;术后 1周内排斥反应组TNF α浓度逐渐升高 ,非排斥反应组TNF α浓度无明显变化并维持在较低水平 ,排斥组IL 1 0水平在术后前 4d显著高于非排斥组 ,但浓度逐渐下降 ,第 5天后显著低于非排斥组 ,非排斥组IL 1 0浓度始终维持在较高水平而无明显改变。结论 IL 1 0和TNF α可以作为预测肝移植术后急性排斥反应的实验指标 ,具有早期、非侵袭性、检测快速、费用低廉的优点 ,易于临床推广。

Objective To evaluate the role of TNF α and IL 10 levels for prediction of early acute rejection after liver transplantation.Methods Fourty one cases of liver transplantation from June 2002 to April 2003 in our hospital were observed.The measurements of TNF α and IL 10 in serum by ELISA method were taken on the last day before operation and within 7 days after operation and the change rules were studied.Results The TNF α and IL 10 serum levels after operation were significantly higher than that before operation.The serum TNF αlevels gradually increased in rejection group,but which in non rejection group had no markedly change and always kept on lower levels within 7 days after operation.In addition,the serum IL 10 levels on the 1st,2nd,3rd,4th days after operation were higher in rejection group than in non rejection group,which in rejection group gradually decreased and were lower than that in non rejection group after the 5th day.The serum IL 10 levels in non rejection group always kept on higher levels without marked changes within 7 days after operation.Conclusion TNF αand IL 10 are better laboratory index in the prediction of early acute rejection after liver transplantation and which are early,non invaded and cheap.