检测血清可溶性白介素-6受体的动态变化在肾移植中的临床应用及其价值

Significances of sequential monitoring of serum soluble interleukin-6 receptor in renal allograft recipients

摘要:

目的：监测肾移植患者手术术后血清可溶性白介素-6受体（soluble interleukin-6 receptor，sIL-6R）水平以及其动态改变，进一步明确其临床价值和作用。方法：详细记录所有入选患者的临床和基线数据资料，采用ELISA 法监测60 例肾移植患者手术前和手术后血清中sIL-6R水平。选择健康志愿者作为正常对照组（n=20）。结果：移植术前，血清sIL-6R的水平肾移植患者与正常对照组相比，差别无统计学意义，移植术后血清sIL-6R水平显著升高，其浓度在第3天时达到最高，针对性治疗有效后其水平逐渐下降，2 周后逐渐下降至术前水平（F=15.23，P=0.003）。同时还发现肾脏移植的患者并发感染时血清sIL-6R水平明显上升（LSD-t=7.32，P=0.004）。结论：动态监测血清sIL-6R水平的改变有助于及时早期判断急性排斥反应的发生，是一种重要的免疫学标志物，同时有助于发现合并感染情况。

Abstract:

Objective：To monitor the levels and changes of serum soluble interleukin-6 receptor（sIL-6R） in renal allograft recipients and to clarify its clinical significances. Methods：Clinical and baseline data of all enrolled patients were recorded in detail and an－other 20 healthy volunteers were chosen as normal controls. Sequential monitoring of serum sIL-6R was conducted by ELISA tech－nique in 60 patients before and after renal allograft. Results：There was no difference in serum sIL-6R level between normal controls and patients before renal allograft. After renal allograft，levels of serum sIL-6R were firstly increased，reaching the peak on the 3rd d then were decreased after targeted treatment and were reduced to levels before renal allograft after two weeks（F=15.23，P=0.003）. Fur－ther study demonstrated that levels of serum sIL-6R were significantly increased in renal allograft recipients complicated with infection（LSD-t=7.32，P=0.004）. Conclusions：Sequential monitoring of immunologic marker，serum sIL-6R in renal allograft recipients can be used to judge the acute rejection reactions at early stage and the combined complications.