中国组织工程研究 ›› 2015, Vol. 19 ›› Issue (46): 7472-7477.doi: 10.3969/j.issn.2095-4344.2015.46.018

• 组织构建基础实验 basic experiments in tissue construction • 上一篇    下一篇

肾移植后早期监测外周血视黄醇结合蛋白4的临床意义

周 宇,郑鳕洋,陆瀚澜,陈 瑜,傅尚希,王立明   

  1. 解放军第二军医大学附属长征医院全军器官移植中心,上海市   200003
  • 收稿日期:2015-09-06 出版日期:2015-11-12
  • 通讯作者: 王立明,博士,教授,主任医师,博士生导师,解放军第二军医大学附属长征医院全军器官移植研究所,上海市200003
  • 作者简介:周宇,男,1985年生,湖北省嘉鱼县人,汉族,2014年解放军第二军医大学毕业,硕士,医师,主要从事肾移植研究。 并列第一作者:郑鳕洋,男,1983年生,云南省曲靖市人,汉族,2009 年华中科技大学毕业,硕士,主治医师,主要从事肾移植及相关移植免疫研究。
  • 基金资助:

    上海市科委基础研究重点项目(11JC1416100)

Continuous monitoring of peripheral blood retinol blinding protein-4 in the early stage after renal transplantation

Zhou Yu, Zheng Xue-yang, Lu Han-lan, Chen Yu, Fu Shang-xi, Wang Li-ming   

  1. Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
  • Received:2015-09-06 Online:2015-11-12
  • Contact: Wang Li-ming, M.D., Professor, Chief physician, Doctoral supervisor, Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China
  • About author:Zhou Yu, Master, Physician, Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China Zheng Xue-yang, Master, Attending physician, Organ Transplantation Institute of PLA, Changzheng Hospital, the Second Military Medical University, Shanghai 200003, China Zhou Yu and Zheng Xue-yang contributed equally to this work.
  • Supported by:

    the Basic Research Program of Shanghai Science and Technology Committee, No. 11JC1416100

摘要:

背景:视黄醇结合蛋白4是早期反映近端肾小管损伤的最敏感的标志物,已被用于急性肾损伤的早期检测,推测其可能与肾移植后急性排斥反应和移植肾功能延迟恢复有关。
目的:分析肾移植后早期外周血中视黄醇结合蛋白4含量与移植肾功能恢复水平的相关性。
方法:连续收集肾移植后受者的静脉血标本。以临床诊断为急性排斥反应的受者20例作为急性排斥反应组,采用回顾性巢式病例对照研究,按照1∶1∶1随机选取肾功能延迟恢复的受者20例为肾功能延迟恢复组,肾功能恢复良好的受者20例为对照组。使用免疫透射比浊法持续检测外周血视黄醇结合蛋白4,同时使用肌氨酸氧化酶法持续监测血肌酐、血尿素氮等指标变化,并对数据进行纵横对比分析。
结果与结论:急性排斥反应组、肾功能延迟恢复组的视黄醇结合蛋白4、血肌酐水平均明显高于对照组(P < 0.05)。急性排斥反应组中视黄醇结合蛋白4和血肌酐在处于排斥时间段内与非排斥时间段内有显著性差异  (P < 0.01);肾功能延迟恢复组中视黄醇结合蛋白4和血肌酐在肾功能异常期与正常期有显著性差异(P < 0.05);视黄醇结合蛋白4与血肌酐、血尿素氮成正相关。在急性排斥反应组中,视黄醇结合蛋白4出现升高的时间早于血肌酐变化;在肾功能延迟恢复组中,视黄醇结合蛋白4出现下降的时间同样早于血肌酐变化。视黄醇结合蛋白4是一可独立检测的生物标志物指标,其与血肌酐、血尿素氮呈正性相关,且在提示移植肾功能变化时存在一定的时间优势,这非常有利于临床对急性排斥反应与肾功能延迟恢复的诊断和监控。
中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

关键词: 组织构建, 组织工程, 视黄醇结合蛋白4, 肾移植, 生物标志物, 急性排斥反应, 移植肾功能延迟恢复

Abstract:

BACKGROUND: Retinol binding protein-4 is a most sensitive biomarker for loss of function of the human proximal renal tubule, which is applied in the early detection of acute kidney injury. It is speculated that retinol binding protein-4 may be associated with acute rejection and delayed graft function after renal transplantation.

OBJECTIVE: To investigate the correlation of peripheral blood retinol binding protein-4 and renal allograft function in the early stage after renal transplantation.
METHODS: The venous blood samples of renal transplantation recipients were continuously collected for detection. As a retrospective nested case-control study, 20 cases of clinical diagnosed acute rejection were selected as acute rejection group. Another 20 cases of delayed graft function and 20 cases with normal graft function were randomly selected according to the ratio of 1:1:1 and taken as delayed graft function group and control group, respectively. Retinol binding protein-4 level was detected by the immune turbidimetric method, and meanwhile, the serum creatinine and blood urea nitrogen levels were dynamically examined by the sarcosine oxidase method. Then, all the data were comparatively analyzed at vertical and horizontal levels.
RESULTS AND CONCLUSION: Compared with the control group, retinol binding protein-4 and serum creatinine levels in the acute rejection group and the delayed graft function group were significantly higher (P < 0.05). Retinol binding protein-4 and serum creatinine levels in the acute rejection group were significantly different between the rejection and non-rejection periods (P < 0.01). Similarly, these two indicators in the delayed graft function group were significantly different between the normal and abnormal renal function periods (P < 0.05). Retinol binding protein-4 levels were positively correlated with serum creatinine and blood urea nitrogen levels. Both in the acute rejection group and delayed graft function group, retinol binding protein-4 levels changed earlier than the serum creatinine levels. Retinol binding protein-4, an independent biomarker indicator, is positively correlated with serum creatinine and blood urea nitrogen and has certain time advantage in predicting the change of renal function, which is very conducive to the clinical diagnosis and monitoring of acute rejection and delayed graft function.
中国组织工程研究杂志出版内容重点:组织构建;骨细胞;软骨细胞;细胞培养;成纤维细胞;血管内皮细胞;骨质疏松组织工程

Key words: Kidney Transplantation, Graft Rejection, Retinol-Binding Proteins, Delayed Graft Function