肝移植急性排斥反应的生化诊断

目的　总结肝移植术后急性排斥反应 (AR)的诊断经验。方法　回顾性分析 70例肝移植患者术后AR的发生率 ;分析AR组、保存 再灌注损伤 (PRI)组移植肝活检前患者生化检测值。结果　 42例次移植肝活检 ,17次发生AR ,2 2次为PRI ;3次为药物中毒。生化检测AR组 ,随发病进展 ,ALT、AST逐渐增高 ,成正相关 (P <0 .0 5 ) ;PRI组随发病进展 ,ALT、AST逐渐降低 ,成负相关 (P <0 .0 5 )。结论　移植肝活检及活检前生化检测对于AR的诊断与鉴别诊断有重要意义。

Laboratory diagnosis of acute rejection in liver transplantation

Objective To summarige the experiences of diagnosis of acute rejection(AR) in liver transplantation. Methods The records of 70 cases with AR after liver transplantation was retrospectively analysed. The biochemical changes of AR group and preservation-reperfusion injury (PRI) group were examined before biopsy of the graft.Results 17 out of 42 biopsies of the graft were diagnosed with AR, 22 with PRI and 3 with drug toxicity. All episodes with AR resolved after anti-rejection therapy. It was found that the dynamic changes of ALT and AST in AR group differed from that in PRI group. ALT and AST levels increased gradually with time in AR group, there was a positive correlation between biochemical parameters and AR(P<0.05);ALT and AST decreased gradually with time in PRI group, and there was a negative correlation between them(P<0.05).Conclusion Biopsy of the graft and the biochemical examination before biopsy are of help in the diagnosis of AR.