肾移植术后肝细胞生长因子的动态监测及临床意义

目的:探讨肝细胞生长因子(HGF)在急性排斥反应的早期诊断、鉴别诊断中的意义。方法:采用双抗体夹心酶联免疫吸附法,对50例肾移植受者血清HGF水平在手术前后进行动态监测。观察肾移植术后发生急性排斥反应(AR)、急性肾小管坏死(ATN)、环孢素(CsA)中毒时血清HGF的变化。结果:术前组HGF水平与对照组相比有统计学意义(P<0.05)。稳定组术后前3天HGF下降明显,2周左右降至对照组水平。AR组在典型症状出现及血Cr升高前1~3d,HGF即有升高,且峰值出现在抗排斥治疗的当天。经甲基泼尼松龙冲击后AR逆转者HGF迅速下降。ATN组HGF升高,与AR组相比有统计学意义(P<0.05)。CsA中毒组HGF水平升高,与AR相比有统计学意义(P<0.05),但与ATN组相比无统计学意义(P>0.05)。结论:动态监测HGF可能作为急性排斥反应的早期诊断敏感指标,并且对ATN、CsA中毒的鉴别诊断也具有一定临床应用价值。

Clinical siginificance of monitoring serum HGF in renal allograft recipients

Objective:To study serum HGF in renal allograft recipients with acute rejection, ATN and CsA-induced nephrotoxicity for the clinical significance of early diagnosis and differential diagnosis.Methods:The sequential monitoring of HGF was conducted by ELISA technique in 50 patients before and after renal transplantation.Results:The levels of HGF before transplantation had significant difference in control. The levels of HGF decreased in the first day to third day posttransplantation, decreased and stabilized after about 2 weeks. The levels of HGF increased 1 to 3 days prior to the clinical symptom in acute rejection and serum Cr, increased in ATN and in CsA-induced nephrotoxicity had significant difference in stable group, but HGF level in ATN had no significant difference in CsA-induced nephrotoxicity .In those patients with acute rejection who responded to the treatment, serum HGF level was reduced significantly after antirejection.Conclusions:It suggests that the sequential monitoring of serum HGF 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.