肾移植术后血清sICAM-1和sVCAM-1的动态监测及临床意义

目的：探讨肾移植术后监测血清可溶性细胞问粘附分子-1(sICAM-1)和可溶性血管细胞粘附分子-1(sVCAM-1)的临床意义。方法：采用ELISA法，动态监测86例肾移植患者手术前后血清sICAM-l和sVCAM-1的变化。结果：移植术前sICAM-1、sVCAM-l与对照组无显著性差别，术后均明显升高，于第3天时达到高峰，l周至2周后降至术前水平。发生急性排斥反应前l-3天血清sICAM-1、sVCAM-1即开始升高，抗排斥治疗有效后逐渐下降。并发感染时sICAM-1、sVCAM-l显著升高，CsA中毒时无明显变化。结论：动态监测血清sICAM-1、sVCAM-l可做为早期辅助诊断急性排斥反应的免疫学指标，有助于急性排斥反应与CsA肾中毒的鉴别。

Sequential monitoring of serum sICAM-1 and sVCAM-1 in renal allograft recipients

Objective:To investigate the effects of serum sICAM-1 and sVCAM-1 in renal allograft recipients with infection, acute rejection and CsA-induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Methods:The sequential monitoring of serum sICAM-1 and sVCAM-1 were conducted by ELISA technique in 86 patients before and after renal transplantation.Results:The levels of serum sICAM-1 and sVCAM-1 increased in the first three day posttransplantation, decreased and stabilized after one to two weeks,increased one to three days prior to the clinical diagnosis in acute rejection and decreased with effective treatment,increased in infection and had no significant difference in CsA-induced nephrotoxicity.Conclusion:Sequential monitoring of serum sICAM-1 and sVCAM-1 of renal allograft recipients can be used to estimate the function of graft,as markers of the early diagnosis and differential diagnosis of acute rejection.