摘要
目的探讨血清胱抑素C(Cys-C)在预测肾移植术后急性排斥反应(AR)中的作用。方法回顾性分析2009年1月至2010年8月肾移植术后6个月内、临床诊断为AR的39例(42次)患者病历资料,记录其在临床确诊为AR前24、48、72、96 h和抗排斥治疗后24、487、2 h的血清肌酐(Scr)和Cys-C浓度,比较Scr和Cys-C在各时间点异常升高的病例次数及其"攀升度"。分析同期未发生AR肾移植患者(n=57)肾移植1周后的Cys-C浓度,后者与50例健康人比较。结果临床确诊为AR 48、72 h前,Cys-C异常升高的病例次数分别为40、38次,而Scr病例次数仅为9、5次,二者比较有显著差异(P<0.01);Cys-C"攀升度"在AR发生前急剧上升,抗排斥治疗后快速下降,与相应时间点的Scr"攀升度"比较有显著差异(P<0.01)。非AR肾移植患者血清Cys-C浓度与健康对照组比较无显著差异(P>0.05)。结论血清Cys-C可能作为一个比Scr更敏感的预测肾移植术后AR发生的指标。
Objective To investigate the role of serum cystatin-C（Cys-C） in predicting acute rejection（AR） after kidney transplantation.Methods 39 patients（42 times） who had undergone kidney transplantation with AR within 6 months from January 2010 to August 2010 were retrospectively analyzed.Concentrations of Scr and serum Cys-C of patients at 24,48,72 and 96 h before AR diagnosis and 24,48,72 h after anti-rejection treatment were recorded,times and climbing degrees of abnormal increasing of Scr and serum Cys-C at different time points were compared.In the same period,Cys-C concentrations of patients without AR detected one week after kidney transplantation were analyzed and compared to those of 50 healthy people.Results Abnormal increasing of serum Cys-C were 40 and 38 times at 48 h and 72 h before AR diagnosis,respectively,while that of Scr were only 9 and 5 times at the same time points,respectively,showing significantly differences between the increasing times of Cys-C and Scr at the corresponding time poits（P0.01）.Climbing degrees of serum Cys-C were dramatically increased before AR diagnosis and decreased rapidly after anti-rejection treatment,demonstrating significant differences when compared to those of Scr at the corresponding time points（P0.01）.There was no significant difference between serum Cys-C concentration in non-AR patients with kidney transplantation and that in healthy people（P0.05）.Conclusion Serum Cys-C may serve as an indicator to predict AR after kidney transplantation which is more sensitive than Scr.
出处
《重庆医学》
CAS
CSCD
北大核心
2011年第16期1596-1597,1600,共3页
Chongqing medicine
关键词
肾移植
移植物排斥
胱抑素C
肌酐
kidney transplantation
graft rejection
cystatin C
creatinin
