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目的探讨血清可溶性细胞间粘附分子-1(sICAM-1)和肿瘤坏死因子(TNF)在肾移植排斥反应监测中的意义。方法采用双抗体夹心法和I_(929)靶细胞法对41例肾移植患者术后血清中sICAM-1和TNF进行动态监测。结果肾移植术后血清sICAM-1和TNF出现相似的变化;术后肾功能稳定恢复组,环孢素A(CsA)肾中毒组与尿毒症组及正常对照组间血清sICAM-1和TNF水平无显著性差异;当发生急性排斥反应(AR)和感染时,血清sICAM-1和TNF显著升高,与正常对照组比较,差异非常显著;发生感染时血肌酐(Cr)无明显变化,而发生AR时,血清sICAM-1和TNF比血Cr提前1～3天升高。结论动态监测血清sICAM-1和TNF的变化,对急性排斥反应的早期诊断和鉴别具有一定的指导意义。
Objective To investigate the significance of serum soluble intercellular adhesion molecule-1 (sICAM-1) and tumor necrosis factor (TNF) in the monitoring of renal allograft rejection. Methods Serum levels of sICAM-1 and TNF in 41 renal transplant recipients were measured by double antibody sandwich method and I 929 target cell method. Results Serum levels of sICAM-1 and TNF were similar in renal transplant recipients. Serum levels of sICAM-1 and TNF in patients with stable recovery of renal function, CsA nephrotoxicity and uremia group and normal control group There was no significant difference between the two groups. Serum levels of sICAM-1 and TNF were significantly increased when acute rejection (AR) and infection occurred, and the difference was significant compared with the normal control group. There was no significant change of serum creatinine When AR occurred, serum sICAM-1 and TNF increased 1 to 3 days earlier than blood Cr. Conclusion The dynamic changes of sICAM-1 and TNF in serum are of guiding significance for the early diagnosis and differential diagnosis of acute rejection.