【摘要】 目的:评价利用肾移植受者术后血清可溶性CD30(sCD30)水平预测急性排异反应的可行性.方法:利用ELISA方法分别在术前、术后5d和10d检测231名肾移植受者的血清sCD30水平,根据肾移植受者术后1mo内临床表现将他们分为三组:急性排异反应组(AR,n=49),肾功能延迟恢复组(DGF,n=11)和正常组(UC,n=171).结果:231名肾移植受者的血清sCD30水平由术前的(178±79)U/mL分别降至术后5d的(52±30)U/mL和术后10d的[(9±5)U/mL,P<0.001].AR组术后5d的sCD30水平为(92±27)U/mL,高于UC组(41±20)U/mL和DGF组[(48±18)U/mL,P<0.001].而术前和术后10d的sCD30水平在三组患者之间的差异无统计学意义.ROC曲线分析结果表明,利用术后5dsCD30水平可以预测近期内即将出现的急性排异反应(曲线下面积0.95).并且,根据ROC曲线分析得出:将65U/mL作为临界点可以较好的预测急性排异反应(特异性91.8%,敏感性87.1%).结论:检测肾移植受者术后5d的血清sCD30水平可以预测移植后早期出现的排异反应.更多还原

【Abstract】 AIM: To evaluate the feasibility of post-transplantation serum soluble CD30 (sCD30) for prediction of acute graft rejection. METHODS: Two hundred and thirty-one patients were included into the study, whose serum levels of sCD30 were detected by ELISA before and after transplantation. Then, they were divided into three groups according to the clinical features one month post-transplantation: acute rejection group (AR,n=49), delayed graft function group (DGF,n=11) and uncomplicated course group (UC,n=171). RESULTS: Significant decrease of sCD30 was detected on day 5 and 10 post-transplantation respectively[ (178±79) U/mL vs (52±30) U/mL, (9±5) U/mL,P<0.001]. Compared with Group UC and DGF, patients of Group AR had higher sCD30 values on day 5 post-transplantation [(92±27) U/mL vs (41±20) U/mL and (48±18) U/mL, P<0.001)]. However, sCD30 levels were not different between three groups before transplantation and on day 10 post-transplantation (P>0.05). Receiver operating characteristic (ROC) curve demonstrated that sCD30 level on day5 post-transplantation differentiated patients who subsequently suffered acute allograft rejection from others (area under ROC curve 0.95). According to ROC curve, 65 U/mL was the optimal operational cut-off level to predict impending graft rejection (specificity=91.8%, sensitivity=87.1%). CONCLUSION: Measurement of sCD30 on 5 day post-transplantation might offer a noninvasive means to recognize patients at risk of impending acute graft rejection during early post-transplantation period.更多还原