ICAM-1和VCAM-1测定在肾移植急性排斥反应中的临床意义

目的探讨血清可溶性细胞间粘附分子１（ｓＩＣＡＭ１）和可溶性血管细胞粘附分子１（ｓＶＣＡＭ１）在肾移植急性排斥反应中的临床意义。方法采用酶联免疫吸附法（ＥＬＩＳＡ）动态监测５６例肾移植患者术后ｓＩＣＡＭ１和ｓＶＣＡＭ１水平的变化。结果肾移植患者术后ｓＩＣＡＭ１和ｓＶＣＡＭ１水平呈规律性变化，急性排斥反应组ｓＩＣＡＭ１为（３９０．６±９１．０）ｎｇ／ｍｌ，ｓＶＣＡＭ１为（１９５７．１±４０３．１）ｎｇ／ｍｌ，明显高于移植肾功能稳定组的（１３７．３±１６．８）ｎｇ／ｍｌ、（１１１８．４±２１０．４）ｎｇ／ｍｌ和ＣｓＡ肾中毒组的（１３２．７±２４．８）ｎｇ／ｍｌ、（１２８５．８±２７０．５）ｎｇ／ｍｌ，差异有非常显著性（Ｐ＜０．０１）。结论ｓＩＣＡＭ１和ｓＶＣＡＭ１可以作为肾移植术后急性排斥反应的免疫学监测指标。

Serum sICAM1 and sVCAM1 in renal allograft recipients

Objective To evaluate the effects of serum soluble intercellular adhesion molecule1 (sICAM1) and soluble vascular cell adhesion molecule1 (sVCAM1) in the monitoring of acute rejection afte renal transplantation. Methods Sequential monitoring of the levels of serum sICAM1 and sVCAM1 were conducted means of ELISA in 56 renal transplantation recipients including 19 with acute rejection and 6 with cyclosporine nephrotoxicity. Results The levels of sICAM1 and sVCAM1 during acute rejection were significantly higher than those with stable allograft function or with cyclosporine nephrotoxicity (P<0.01).On successful antirejection therapy,the level of sICAM1 came down to the normal level several days after treatment.The level of sVCAM1 in the patients of steroidresistant rejection with ATG antirejection therapy remained high for one month after rejection. Conclusions Serum sICAM1 and sVCAM1 can be served as potent markers in the monitoring of acute rejection after renal transplantation.