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探讨外周血淋巴细胞(peripheral blood lymphocyte,PBL)穿孔素和颗粒酶B mRNA检测对肾移植急性排斥反应(AR)的早期诊断价值。采用RT-PCR方法动态检测67例肾移植AR患者外周血淋巴细胞穿孔素和颗粒酶B mRNA的表达水平,同时检测所有患者肌酐(Cr)表达水平情况,比较各时间点穿孔素、颗粒酶B mRNA及Cr表达水平,并探讨穿孔素、颗粒酶B与AR的关系。移植后1d与移植前1d比较,PBL穿孔素、颗粒酶B mRNA表达水平比较无明显差异性(P>0.05),Cr表达水平明显下降(P<0.05);AR前3d较之前各时间点比较,PBL穿孔素、颗粒酶B mRNA表达水平明显上升(P<0.05),而Cr表达水平明显下降(P<0.05);AR后1d时PBL穿孔素、颗粒酶B mRNA表达水平达到最高峰,随后逐渐下降(P<0.05),而AR后5d时Cr表达水平达到最高峰,随后逐渐下降(P<0.05);PBL穿孔素、颗粒酶B mRNA表达水平升高时间比Cr早4d,AR患者经MP/OKT3冲击治疗后,PBL穿孔素和颗粒酶B mRNA表达水平逐渐降低至原有基础水平。PBL穿孔素和颗粒酶B mRNA在AR早期诊断和抗排斥反应疗效评估等方面具有一定的临床价值。
To investigate the value of perforin and granzyme B mRNA detection of peripheral blood lymphocytes (PBL) in the early diagnosis of acute rejection after renal transplantation. The mRNA expression of perforin and granzyme B in peripheral blood lymphocytes of 67 renal transplant recipients were detected by RT-PCR. The creatinine (Cr) expression levels in all patients were measured. Perforin, granzyme B mRNA and Cr expression levels, and explore the relationship between perforin, granzyme B and AR. There was no significant difference in the expression of perforin and granzyme B mRNA in PBL (P> 0.05) and the expression of Cr in PBL (P <0.05) at 1 day after transplantation compared with that at 1 d before transplantation (P <0.05), whereas the expression of Cr decreased significantly (P <0.05). The expression of perforin and granzyme B mRNA in PBL reached the peak at 1 day after AR (P <0.05). The expression level of Cr reached a peak at 5 d after AR, and then decreased gradually (P <0.05). The expression of perforin and granzyme B mRNA in PBL increased 4 d earlier than Cr, After MP / OKT3 impact treatment, the expression of perforin and granzyme B mRNA in PBL decreased gradually to the original level. PBL perforin and granzyme B mRNA in AR early diagnosis and evaluation of anti-rejection efficacy evaluation has some clinical value.