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.doc

《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.doc》由会员上传分享，免费在线阅读，更多相关内容在学术论文-天天文库。

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<0.001］.AR组术后5d的sC

2、D30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】可溶性CD30；移植物排异；敏感性与特异性；肾移植　　【Abstract】AI

3、M:ToevaluatethefeasibilityofposttransplantationserumsolubleCD30(sCD30)forpredictionofacutegraftrejection.METHODS:Twohundredandthirtyonepatientswereincludedintothestudy,whoseserumlevelsofsCD30weredetectedbyELISAbeforeandaftertransplantation.Then,theyweredividedintothreegroupsaccordingtotheclinica

4、lfeaturesonemonthposttransplantation:acuterejectiongroup(AR,n=49),delayedgraftfunctiongroup(DGF,n=11)anduncomplicatedcoursegroup(UC,n=171).RESULTS:SignificantdecreaseofsCD30wasdetectedonday5and10posttransplantationrespectively［(178±79）U/mLvs(52±30)U/mL,(9±5)U/mL,P<0.001］.ComparedwithGroupUCan

5、dDGF,patientsofGroupARhadhighersCD30valuesonday5posttransplantation［(92±27)U/mLvs(41±20)U/mLand(48±18)U/mL,P<0.001)］.However,sCD30levelswerenotdifferentbetweenthreegroupsbeforetransplantationandonday10posttransplantation(P>0.05).Receiveroperatingcharacteristic(ROC)curvedemonstratedthatsCD3

6、0levelonday5posttransplantationdifferentiatedpatientswhosubsequentlysufferedacuteallograftrejectionfromothers(areaunderROCcurve0.95).AccordingtoROCcurve,65U/mLwastheoptimaloperationalcutoffleveltopredictimpendinggraftrejection(specificity=91.8%,sensitivity=87.1%).CONCLUSION:MeasurementofsCD30on5

7、dayposttransplantationmightofferanoninvasivemeanstorecognizepatients6atriskofimpendingacutegraftrejectionduringearlyposttransplantationperiod.　　【Keywords】solubleCD30;graftrejection;sensitivityandspecificity;kid