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移植肾急性排斥反应早期预警模型和无创诊断模型的建立

Early Warning Model and Noninvasive Diagnosis Model for Acute Rejection

中文摘要英文摘要

目的 建立适用于临床实际工作的急性排斥反应早期预警模型和无创诊断模型,并评价其预警和无创诊断急性排斥反应能力。方法 在肾移植术前和术后第1、4和7天应用蛋白质液相芯片技术检测KIM-1和OPN的水平;流式微球载体检测IL-2、IL-6、TNF-α和IFN-γ;进行HLA-G 14-bp基因多态性分型。结果 联合HLA-G 14-bp基因多态性分型试验、术后第1天的血清KIM-1和术后第7天的血清OPN三项指标,建立了三个急性排斥反应早期预警模型。在三个模型中,两项及以上指标阳性的模型预警急性排斥反应的灵敏度和特异度为84.38%和91.11%,可平均提前6.44±6.12天预警急性排斥反应的发生。联合体外淋巴细胞刺激--流式微球载体检测IL-2、IL-6、TNF-α和IFN-γ四项指标,建立了四个急性排斥反应的无创诊断模型。这四个模型中,三项及以上指标阳性的模型无创诊断急性排斥反应的灵敏度和特异度为86.36%和93.33%。 结论 成功建立了简便、有效的适用于临床实际工作的高灵敏度和特异度的急性排斥反应早期预警模型和无创诊断模型。?????

Objective To establish the early predict models and noninvasive diagnostic models for acute rejection, and its capability of predicting and diagnosing acute rejection were evaluated. Methods The levels of KIM-1 and OPN were measured before and at 1, 4 and 7 days after renal transplantation; the flow cytosolic microspheres were used to detect IL-2, IL-6, TNF-α and IFN-γ. ; HLA-G 14-bp gene polymorphism type. Results Three early warning models of acute rejection were established in combination with the HLA-G 14-bp polymorphism test, serum KIM-1 on the first postoperative day, and serum OPN on the seventh postoperative day. In the three models, the sensitivity and specificity of the early warning of acute rejection in the model with two or more indicators were 84.38% and 91.11%, and the acute rejection reaction could be early warning 6.44±6.12 days in advance. In combination with in vitro lymphocyte stimulation, flow cytometers were used to detect four markers of IL-2, IL-6, TNF-α and IFN-γ, and four noninvasive diagnostic models for acute rejection were established. Among the four models, the sensitivity and specificity of non-invasive diagnosis of acute rejection were 86.36% and 93.33%, respectively. Conclusion A simple and effective early warning model and non-invasive diagnosis model for acute rejection with high sensitivity and specificity suitable for clinical practice have been successfully established.?????

徐翠香、靳占奎、田普训

临床医学内科学

肾移植排斥反应诊断基因多态性免疫状态模型

Kidney TransplantationRejectionDiagnosisGene PolymorphismImmune StateModel?????

徐翠香,靳占奎,田普训.移植肾急性排斥反应早期预警模型和无创诊断模型的建立[EB/OL].(2018-05-28)[2025-08-18].http://www.paper.edu.cn/releasepaper/content/201805-249.点此复制

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