肾移植术后血清IL-6水平的动态监测及临床意义

目的：观察肾移植术后发生急性排斥反应、感染、CsA中毒时血清IL-6的变化,以探讨IL-6在急性排斥反应的早期诊断、鉴别诊断中的意义。方法：采用双抗体夹心酶联免疫吸附法,对106例肾移植患者血清IL-6活性水平于肾移植手术前后进行动态监测。结果：肾移植术前,IL-6与对照组比较差别无显著性意义。术后第1天明显升高,2周左右基本降至术前水平。发生急性排斥反应前1-3天。血清IL-6即有升高,峰值出现在抗排斥反应治疗的当天,经甲基本降至术前水平,发生急性排斥反应前1-3天,血清IL-6即有升高,峰值出现在抗排斥反应治疗的当天,经甲基泼尼松尼（MP）冲击有效后迅速下降,治疗无效者,血清IL-6持续在高水平,并发感染时,IL-6也显著升高,与急性排斥反应组相比差别无显著性意义;而CsA中毒时,IL-6变化不明显。结论：动态监测IL-6可以作为急性排斥反应的早期诊断,鉴别诊断的免疫生物学指标。

Evaluation of sequential monitoring of IL-6 of renal allograft recipients

Purpose:To study IL 6 in renal allograft recipients with infection, acute rejection and CsA induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Method:The sequential monitoring of IL 6 were conducted by ELISA technique in 106 patients before and after renal transplantation.Result:The levels of IL 6 increased in the first day posttransplantation, decreased and stabilized after 2 weeks, increased 1 to 3 days prior to the clinical diagnosis in acute rejection, increased in infection and had no significant difference in CsA induced nephrotoxicity.Conclusion:It suggests that the sequential monitoring of serum IL 6 of renal allograft recipients can be used to estimate the function of graft, as markers of the early diagnosis and differential diagnosis of acute rejection.