肾移植后测定血清可溶性细胞间粘附分子-1的临床意义

目的　探讨血清可溶性细胞间粘附分子 1(sICAM 1)在肾移植术后免疫学监测中的价值。方法　采用酶联免疫吸附法 (ELISA)动态监测 5 6例肾移植患者术后血清sICAM 1的变化。结果　肾移植患者术后发生排斥反应时 ,其sICAM 1水平 (390 .6 μg/L±91.0 μg/L)明显高于移植肾功能稳定者 (137.3μg/L±16 .8μg/L)和环孢素A(CsA)肾中毒者 (132 .7μg/L±2 4.8μg/L) ,差异有极显著性 (P <0 .0 1) ;抗排斥反应治疗有效后 ,sICAM 1逐渐降至正常水平 ;CsA肾中毒者的sICAM 1水平无明显变化。结论　肾移植术后动态监测患者血清sICAM 1水平的变化 ,有助于急性排斥反应的诊断、鉴别诊断及抗排斥治疗的疗效评价 ,可以作为肾移植术后急性排斥反应的免疫学监测指标。

Measurement of serum sICAM-1 in renal allograft recipients and its clinical implication

Objective To evaluate the values of serum soluble intercellular adhesion molecule-1 (sICAM-1) in monitoring acute rejection after renal transplantation.Method The levels of serum sICAM-1 was sequentially monitored by means of ELISA in 56 renal transplantation recipients including 19 with acute rejection and 6 with cyclosporine nephrotoxicity. Results The level of sICAM-1 during acute rejection was significantly higher than those with stable allograft function or with cyclosporine nephrotoxicity ( P < 0.01 ). After antirejection therapy was successfully given, the level of sICAM-1 came down to the normal level. Conclusions Sequential monitoring of serum sICAM-1 is helpful for the diagnosis and differential diagnosis of acute rejection as well as the evaluation of the acute rejection therapeutic effects. Serum sICAM-1 can be used as a potent marker in monitoring acute rejection after renal transplantation.