肝移植术后血清可溶性人类白细胞Ⅰ类抗原的动态观察

Dynamic observation on the value of serum soluble human leukocyte class Ⅰ antigen after liver transplantation

目的 :探讨动态检测血清可溶性人类白细胞Ⅰ类抗原 (serumsolublehumanleukocyteclassⅠanti gen ,sHLA Ⅰ )在监测肝移植术后急性排斥反应方面的诊断价值。方法 :采用ELISA法检测 10例肝移植患者术前及术后一个月血清sHLA Ⅰ的动态变化。结果 :急性排斥反应前 4～ 6d(肝酶ALT尚未明显升高 )sHLA Ⅰ即明显升高 ,排斥逆转后逐渐下降 ;当出现肝动脉并发症时 ,sHLA Ⅰ伴随肝酶ALT同步升高 ;感染时sHLA Ⅰ无明显升降。结论 :sHLA Ⅰ能预测肝移植急性排斥反应 ,结合肝功能酶学指标有助于克服其特异性差的缺点。

Objective:To evaluate the value of serum soluble human leukocyte class Ⅰ antigen(sHLA-Ⅰ) in monitoring the acute rejection after liver transplantation.Methods:The serum levels of sHLA-Ⅰ in 10 liver transplantation recipients were measured with ELISA dynamically from the day before transplantation to 30 days after transplantation. Ten normal serums were measured with the same method as control.Results:Different levels of standard sHLA-Ⅰ were measured with ELISA and linear regression equation was acquired as bellow:Y=0.326LnX+0.257,γ=0.962. The normal levels of serums sHLA-Ⅰ of Chinese are(851±719)μg/L. In liver transplantation recipients,the serum sHLA-Ⅰ levels increased significantly 4～6 days before acute rejection were confirmed or just after the hepatic artery thrombosis. When the acute rejections were controlled or the hepatic artery was repaired the sHLA-Ⅰ levels dropped rapidly. We noticed that in the early rejection periods the serum sHLA-Ⅰ levels increased significantly while the alamine aminotransferase levels increased slightly at the same time. When infections occurred,the serum sHLA-Ⅰ levels fluctuated irregularly and slightly.Conclusion:The serum sHLA-Ⅰ combind with ALT can be used as a parameter of predicting acute rejections.