血清可溶性血管细胞粘附分子1测定在肾移植急性排斥反应中的临床意义

采用酶联免疫吸附法（ Ｅ Ｌ Ｉ Ｓ Ａ） 监测５６ 例肾移植患者术后血清可溶性血管细胞粘附分子 １ （ｓ Ｖ Ｃ Ａ Ｍ １ ） 水平的变化，旨在探讨其在肾移植术后免疫学监测中的价值。结果发现： 肾移植患者术后ｓ Ｖ Ｃ Ａ Ｍ １ 水平呈规律性变化， 急性排斥反应组ｓ Ｖ Ｃ Ａ Ｍ １ 水平明显高于移植肾功能稳定组和环胞素 Ａ（ Ｃｓ Ａ） 肾中毒组， 差异非常显著（ Ｐ＜ ００１ ） ； 与排斥反应前水平比较， 差异亦非常显著（ Ｐ＜ ００１ ） 。对激素治疗敏感的排斥反应， ｓ Ｖ Ｃ Ａ Ｍ １ 逐渐降至正常水平； 耐激素的排斥反应应用 Ａ Ｔ Ｇ 治疗后， ｓ Ｖ Ｃ Ａ Ｍ １ 在排斥反应后１ 个月内仍维持在较高水平。 Ｃｓ Ａ 肾中毒组， ｓ Ｖ Ｃ Ａ Ｍ １ 水平无明显变化。结果表明，肾移植术后动态监测ｓ Ｖ Ｃ Ａ Ｍ １ 水平的变化， 有助于急性排斥反应的诊断和鉴别诊断， 有助于指导临床治疗。

Measurement of Serum sVCAM 1 in Renal Allograft Recipients and Its Clinical Implications

quential monitoring of the level of serum soluble vascular cell adhesion molecule 1 (sVCAM 1) was conducted in 56 renal transplantation recipients including 19 with acute rejection and 6 with cyclosporine nephrotoxicity The results showed the level of sVCAM 1 in the period of acute rejection episodes was significantly higher than those with stable allograft function or with cyclosporine nephrotoxi city( P <0 01) The level of sVCAM 1 in the patients with steroid sensitive rejection dropped to the normal several days after treatment The level of sVCAM 1 in the patients with steroid resistant rejection with ATG anti rejection therapy remained high for one month after rejection It was concluded that sequential montoring of serum sVCAM 1 is helpful for the diagnosis and differential diagnosis of acute rejection and helpful for clinical therapy