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1、利用肾移植受者术后血清可溶性CD30预测早期急性排异反应【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&
2、lt;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.【关键词
3、】可溶性CD30;移植物排异;敏感性与特异性;肾移植 【Abstract】AIM:Toevaluatethefeasibilityofpost12transplantationserumsolubleCD30(sCD30)forpredictionofacutegraftrejection.METHODS:Twohundredandthirtyonepatientswereincludedintothestudy,whoseserumlevelsofsCD30weredetectedbyELISAbeforeandaftertransplant
4、ation.Then,theyweredividedintothreegroupsaccordingtotheclinicalfeaturesonemonthposttransplantation:acuterejectiongroup(AR,n=49),delayedgraftfunctiongroup(DGF,n=11)anduncomplicatedcoursegroup(UC,n=171).RESULTS:SignificantdecreaseofsCD30wasdetectedonday5and10posttransplantation
5、respectively[(178±79)U/mLvs(52±30)U/mL,(9±5)U/mL,P<0.001].ComparedwithGroupUCandDGF,patientsofGroupARhadhighersCD30valuesonday5posttransplantation[(92±27)U/mLvs(41±20)U/mLand(48±18)U/mL,P<0.001)].However,sCD30levelswerenotdifferentbetweenthreegroupsbeforetransplantationa
6、ndonday10posttransplantation(P>0.05).Receiveroperatingcharacteristic(ROC)curvedemonstratedthatsCD30levelonday5posttransplantationdifferentiatedpatientswhosubsequentlysufferedacuteallograftrejectionfromothers(areaunderROCcurve0.95).AccordingtoROCcurve,65U/mLwastheoptimalope
7、rationalcutoffleveltopredictimpendinggraftrejection(specificity=91.8%,sensitivity=87.1%).CONCLUSION:12MeasurementofsCD30on5dayposttransplantationmightofferanoninvasivemeanstorecognizepatientsatriskofimpendingacutegraftrejectionduringearlyposttransplantationperiod. 【Keywords
8、】solubleCD30;graftrejection;sensitivityandspecificity;