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目的:研究肾移植早期血清及尿液肿瘤坏死因子(tumornecrosisfactor,TNF)水平及其临床意义。方法:分组及动态监测55例肾移植患者早期血清及尿液TNF水平。结果:术后3d血清和尿液TNF均明显升高,与术前和术后其他各组比较,P<0.01。血清和尿液TNF在手术1周后均显著下降,但血清TNF水平仍高于术前,尿液TNF水平低于术前。血清TNF水平在发生急性排斥反应时显著增高,术后平稳组及急性肾功能衰竭组无明显变化。急性排斥反应组中使用甲基氢化泼尼松冲击治疗有效者,TNF下降,未降者排斥反应不能逆转。结论:肾移植早期动态监测血清及尿液TNF可敏感地预示急性排斥反应的发生,但不能单凭TNF水平变化作为急性排斥反应的诊断依据,而应结合临床表现及其他检查作综合分析
Objective: To study the level of tumor necrosis factor (TNF) in serum and urine of early renal transplantation and its clinical significance. Methods: The serum and urine TNF levels in 55 renal transplant recipients were grouped and dynamically monitored. Results: The levels of TNF in serum and urine increased significantly after operation, P <0.01 compared with other groups before and after operation. Serum and urinary TNF decreased significantly after 1 week of operation, but the level of serum TNF was still higher than that before operation. The level of TNF in urine was lower than that before operation. Serum TNF levels were significantly increased in acute rejection, stable group and acute renal failure group did not change significantly. Acute rejection group using methylprednisolone impact treatment effective, TNF decreased, did not drop those rejection can not be reversed. Conclusion: The dynamic monitoring of serum and urine TNF in early stage of kidney transplantation predicts the occurrence of acute rejection. However, the change of TNF level alone can not be used as the basis of diagnosis of acute rejection, but should be combined with clinical manifestations and other tests for comprehensive analysis