移植肾急性排斥时血栓素A2、前列环素代谢改变及其对肾小球滤过率的影响

用放射免疫法检测２１例移植肾急性排斥时，肾移植患者尿液以及血浆血栓素Ｂ２（ＴＸＢ２）和６－酮－前列腺素Ｆ１α（６－ｋｅｔｏ－ＰＧＦ１α）浓度，并检测４例不可逆急性排斥和７例慢性排斥移植肾切除后肾组织ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量。发现急性排斥出现时，尿中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量均明显升高，ＴＸＢ２增多出现较早；血浆ＴＸＢ２浓度也显著增加，６－ｋｅｔｏ－ＰＧＦ１α浓度下降。尿液和血浆中ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值增大。正常肾组织标本中，肾髓质ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α含量为皮质的４～５倍，皮髓质中ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值水平相同。不可逆急性排斥肾组织中，肾皮质ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值明显高于髓质。急性排斥时，尿液中ＴＸＢ２和６－ｋｅｔｏ－ＰＧＦ１α比值变化与肾皮质平行。分析表明，急性排斥时，尿液ＴＸＢ２／６－ｋｅｔｏ－ＰＧＦ１α比值增大和移植肾肾小球滤过率负相关。

Alterations of TXB2 and PGI2 metabolism in acute renal allograft rejection and their influence on GFR

Using radioimmunological assay, TXB2 and 6-keto-PGF1αcontents were determined in urine and plasma from 21 patients with acute renal graft rejection episodes, and in renal tissues from 4 patients with irreversible acute rejection and 7 with chronic rejection undergoing the re-moral of renal grafts.The results indicated that urinary TXB2 and 6-keto-PGF1αcontents were in-creased in acute rejection.In plasma, TXB2 was obviously elevated and 6-keto-PGF1αcontent de-clined.In urine and plasma, the ratio of TXB2/6-keto-PGF1αwas increased.In normal renal tis-sues, the TXB2 6-keto-PGF1αin contents in the medulla were 4～5 flod of those in cortical tissues.In the renal tissues of irreversible acute rejection, the ratio of TXB2 6-keto-PGF1αin cortical tissues was predominantly higher than in the medulla.In acute rejection, urinary TXB2/6-keto-PGF1αra-tio change was parallel to that in cortical tissue.It was suggested that the increase of TXB2/6-ke-to-PGF1αratio in urine was negatively related to GFR in renal grafts.