同种异体肾移植患者B型钠尿肽水平的临床观察

目的：探讨同种异体肾移植患者和发生急性排斥反应时血浆B型钠尿肽（BNP）水平及其临床意义。方法：采用免疫夹心化学发光法检测17例首次肾移植患者术前1d、术后第1天、第2天、第3天、1周、2周和3个月血BNP浓度。17例健康体检者作对照。结果：肾移植患者术前1d血BNP浓度显著高于健康对照组（P〈0．01）。肾移植术后血BNP浓度呈下降趋势（χ^2=14．25，P=0．027）。13例没有发生急性排斥反应的患者血BNP浓度术后1周和3个月与肾移植术前比较差异有显著性（P〈0．05）；4例发生急性排斥反应患者，发生急性排斥反应当天的血BNP浓度显著增高，加强抗排斥治疗后很快下降。结论：肾移植成功后可以降低血BNP水平，但发生急性排斥反应时血BNP浓度显著增高。因此，血BNP浓度可作为早期诊断移植肾急性排斥反应发生的敏感指标。

Clinical study of B-type natriuretic peptide levels in kidney transplant recipients

Objective:To investigate the clinical significance of B-type natriuretic peptide (BNP) in kidney transplant recipients with or without acute rejection. Methods:The plasma BNP levels in 17 transplant recipients were measured at the different time intervals. Results:The BNP levels in transplant recipients was significantly higher than those in control healthy individuals before transplantation (P<0.01). The BNP levels in 13 recipients without acute rejection decreased gradually after operation (x2=14.25,P=0.027),especially in the first week and the third month after operation (P<0.05). The BNP levels in 4 recipients with acute rejection increased significantly during the period of rejection and decreased markedly after adjusting the immunosuppressant drug. Conclusion:The BNP levels decrease after successful kidney transplantation and increase after acute rejection, which means the BNP levels may be potentially useful for the early diagnosis of acute rejection.