【摘要】 目的 :通过对肾移植患者血浆可溶性血栓调节蛋白 (solublethrombomdulin ,sTM)、可溶性血管内皮细胞蛋白C受体 (endothelialproteinCreceptor ,sEPCR)、血管性血友病因子 (vonWillebrandfactor,vWF)含量水平的动态检测分析 ,探讨其在肾移植及移植排斥反应中的应用价值。方法 :采用双抗体夹心ELISA法检测 4 2例肾移植患者手术前后、排斥反应治疗过程中的sTM、sEPCR、vWF含量。结果 :肾移植术后sTM、sEPCR、vWF含量水平较术前明显增高 (P <0 0 5 )、与正常对照组比较有显著性差异 (P <0 0 1) ;发生移植排斥反应者较无排斥者有明显差异 (P <0 0 5 ) ;肾移植术前、排斥反应有效治疗后与正常对照组比较无显著差异 (P >0 0 5 ) ;肾移植患者sTM、sEPCR、vWF各指标间呈正相关 (r =0 5 95 ,P <0 0 1,r =0 5 81,P <0 0 1,r =0 6 0 6 ,P <0 0 1)。结论 :sTM、sEPCR、vWF均可作为肾移植患者血管内皮的免疫损伤标志物 ,联合动态监测sTM、sEPCR、vWF的含量在观察肾移植手术创伤程度、排斥反应的早期诊断和治疗效果的监测等方面均有重要的临床应用价值。更多还原

【Abstract】 Objective:To investigate the clinical significance of soluble thrombomdulin (sTM)、endothelial protein C receptor (sEPCR) and von Willebrand factor (vWF) in patients with renal transplantation and reject reaction.Methods:The plasma levels of sTM, sEPCR and vWF were successively determined by double antibody sandwich enzyme linked immunoadsordent assay (ELISA) in 42 patients with renal transplantation and reject reaction, and were compared with normal groups.Results:The levels of sTM, sEPCR and vWF in postoperative of renal transplantation patients were higher than those in preoperative ( P <0 05), and much higher than those in the controls ( P <0 01). The levels of sTM, sEPCR and vWF in rejection patients were higher than those in no rejection ones ( P <0 05). Those in patients with anti rejection therapy were lower than those in patients without anti rejection therapy ( P <0 05). Those in patients with preoperative of renal transplantation and patients with anti rejection therapy were no difference than those in controls( P >0 05). In patients with renal transplantation, the levels of sTM, sEPCR and vWF each have positive correlation(r=0 595 P <0 01,r=0 581 P <0 01,r=0 606 P <0 01).Conclusion:In patients with renal transplantation, sTM, sEPCR and vWF can be as the markers of endothelial damage. For diagnosis and therapy, it is very important to detect them. [更多还原