【摘要】 目的研究肾移植术后患者肿瘤坏死因子(TNF)与全血环孢素A(CsA)浓度的临床意义。方法采用放射免疫法测定血清和尿TNF,FPIA法测定CsA全血浓度。结果急性排斥组患者血、尿TNF(1.03±0.26ng/L,0.44±0.36ng/L)明显高于肾功能稳定组(0.86±0.21ng/L ,0.34±0.29ng/L),并且可早于血肌酐升高1～3d。而CsA肾中毒组的血、尿TNF(0.91±0.22ng/L、0 40±0.27ng/L)与肾功能稳定组无明显差别。CsA血药浓度在急性排斥反应组明显降低 ,而CsA肾中毒组显著升高。结论TNF和CsA血药浓度测定有助于鉴别急性排斥反应和CsA肾中毒 ,具有重要的临床意义更多还原

【Abstract】 Aim To evaluate the clinical significance of determination of serum or urine tumor necrosis factos (TNF) and whole blood concentration of cyclosporin A (CsA) in renal transplanted recipients. Methods The serum and urine TNF levels with radioimmunoassay and whole blood concentration of CsA with FIPA method were determined in 55 renal transplanted recipients. Results Serum and urine TNF levels in group of acute rejection (1.03±0.26 ng/L, 0.44±0.36 ng/L) were significantly higher than those in group of functionally stable renal graft(0.86±0.21ng/L, 0.34±0.29 ng/L) and there was an obvious elevation of the TNF as early as 1～3 days before the rise of serum creatine. But the TNF levels in CsA nephrotoxicity group (0.91±0.22 ng/L, 0.4±0.27 ng/L) were not significantly different from those in functionally stable renal graft group. The blood concentration of CsA was decreased in group of acute rejection and increased in group of CsA nephrotoxicity. Conclusion Determining TNF and CsA could distinguished the graft rejection from CsA nephrotoxocity. It has important clinical significance for regulation of the dosage of CsA.更多还原