【摘要】 目的:探讨CD20+细胞在移植肾排斥反应中浸润程度与移植肾预后的关系。方法:选取93例肾移植后穿刺患者,肾活检组织标本行CD20免疫组化染色。并对病理结果行半定量分析,根据CD20+细胞在肾组织内浸润程度,分为阴性组48例(N组,CD20+细胞浸润占肾小管间质面积<10%)、中度浸润组25例(M组,CD20+细胞浸润占肾小管间质面积≥10%<50%)和重度浸润组20例(H组,CD20+细胞浸润占肾小管间质面积≥50%)。分析CD20+细胞浸润的程度与移植肾预后的相关性。随访内容包括患者穿刺活检后的临床资料,随访内容包括患者的肌酐、蛋白尿变化及移植肾的生存状况等指标。结果:三组患者在年龄、性别、组织活检时间以及移植的次数均没有明显差异(P>0.05);穿刺活检后12个月的肌酐N组[(276.79±240.78)μmol/L]低于M组[(360.16±290.30)μmol/L];M组低于H组[(466.50±330.53)μmol/L],P<0.05;CD20+浸润组的患者的4年生存率明显低于阴性组(P<0.05);穿刺活检后12个月内,N组穿刺后出现蛋白尿的概率明显低于M组和H组(P<0.05)。结论:CD20+细胞在肾移植内浸润的程度与移植肾预后有明显相关性。更多还原

【Abstract】 Objective:To analyze the infiltration of CD20-positive lymphocytes in the reject reaction of renal allograft and the relations with the graft survival. Method:We examined 93 biopsy samples of renal allograft patients.CD20 was assayed by immunochemistry staining.These cases were divided into three groups according to the degree of CD20 positive cell infiltration with semiquantitative method,Three groups,negative group(<10%,n=48),moderate infiltration(≥10%,<50%,n=25)and severe group(≥50%,n=20)in all 93 patients,to analyze the relations between the infiltration of CD20-positive lymphocytes and graft survival.All cases were collected the information of treatment,serum creatinine(SCr),albuminuria and graft surviva1. Result:Three groups have no difference with age,gender,biopsy time and times of transplantation(P>0.05).In the twelfth month of the following-up,the average SCr of severe group(466.50±330.53μmol/L)was higher than that moderate group[(360.16±290.30)mol/L]P<0.05;the moderate group was higher than that of negative group[(276.79±240.78)μmol/L]P<0.05.The graft survival ratio of severe group was lower than that of moderate and negative groups(P<0.05)in 4 years.The ratio of the biopsy patients with albuminuria of severe group was higher than that of moderate and negative group(P<0.05). Conclusion:The degree of CD20 positive cell infiltration in the renal allograft was an important factor for evaluating allograft prognosis.更多还原