外周血淋巴细胞白细胞介素-2 mRNA监测在肾移植术后早期急性排斥反应诊断中的应用

目的 探讨实时定量聚合酶链反应(PCR)监测外周血淋巴细胞(PBL)白细胞介素(IL)-2 mRNA表达在肾移植术后早期急性排斥反应(AR)诊断中的应用.方法 对2008年5月至2009年8月进行肾移植术的68例患者,测定术前、术后第1、3、7、14 d PBL的IL-2 mRNA表达.依据围手术期急性排斥反应的有尤分为AR组和对照组.结果 术后6～20 d共有9例患者发生AR.术前、术后第1、3天,AR组和对照组患者PBL的L-2 mRNA表达分别为(0.182±0.230)和(0.176±0.015)、(0.174±0.018)和(0.168±0.023),(P>0.05);术后第7天,两组PBL的IL-2 mRNA表达分别为(0.270±0.056)和(0.195±0.053),(P<0.05);术后第14天,两组PBL的IL-2 mRNA表达分别为(0.320±0.043)和(0.181±0.034)(P<0.01).结论 实时荧光定量PCR检测PBL的IL-2mRNA表达可能是监测肾移植术后早期急性排斥反应的有效方法,并有助于AR的及时治疗和预后判断.

Application of peripheral blood lymphocyte IL-2 mRNA evaluation in early acute rejection diagnosis of patients with renal transplantation

Objective To study the application of peripheral blood lymphocyte (PBL) interleukin (IL) -2 mRNA evaluation with real-time polymerase chain reaction ( PCR) for the early acute rejection (AR) diagnosis of patients with renal transplantation. Methods For 68 renal recipients from May 2008 to August 2009, PBL IL-2 mRNA expression was detected before and 1,3,7, 14 days after operation. All patients were divided into AR group and control group. Results On the postoperative day 6 to 20, AR occurred in 9 cases. Before operation and 1, and 3 days after operation, PBL IL-2 mRNA expression in AR group and control group was (0. 182 ±0. 230) and (0.176 ±0. 015), (0. 174 ±0. 018) and (0. 168 ± 0. 023) (P > 0.05 ). On the postoperative day 7, PBL IL-2 mRNA expression in AR group and control group was (0. 270 ± 0.056) and (0. 195 ± 0.053 ) respectively (P < 0. 05). On the postoperative day 14, PBL IL-2 mRNA expression in AR group and control group was (0. 320 ±0. 043) and (0. 181 ±0. 034) respectively ( P < 0.01). Conclusion PBL IL-2 mRNA evaluation with real-time PCR is the effective method for monitoring early AR on renal recipients, and is beneficial to the timely treatment and the prognostic decision.