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目的 :观察肾移植术后血清可溶性血小板T细胞活化抗原 1 (sPTA1 )水平及细胞膜性血小板T细胞活化抗原 1 (mPTA1 )的表达与排斥反应 (AR)的相关性。 方法 :选取 1 7例围手术期同种尸体肾移植患者以及 2例术后超过 1年的AR的患者 ,根据患者的不同病况每周采取血样 ,采用夹心ELISA法测定血清sPTA1水平 ,流式细胞术检测淋巴细胞mPTA1表达 ,对明确有排斥反应、可疑有排斥反应以及不能区分排斥反应的患者在B超引导下行移植肾活检穿刺病理检查。 结果 :术前sPTA1水平及mPTA1表达与对照无显著差异 (P >0 0 5)。术后第 1天sPTA1即有高水平的表达 ,与对照组差异显著 (P <0 0 5)。 1 9例尸体肾移植患者中经病理证实的 5例排斥反应患者sPTA1显著升高 ,mPTA1表达增强 ,与对照组差异非常显著 (P <0 0 1 )。经激素冲击治疗后 ,血清sPTA1下降 ,mPTA1表达下降。而且sPTA1水平变化早于AR的临床表现 ,持续时间较长。 结论 :PTA1可以作为移植物AR的预警和监测指标 ,与病理检查的结果有较好的一致性 ;PTA1水平变化早于临床表现和病理学变化
OBJECTIVE: To observe the correlation between serum soluble platelet T-cell activating antigen 1 (sPTA1) level and plasma membrane T cell activating antigen 1 (mPTA1) expression and rejection (AR) after renal transplantation. Methods: Totally 17 patients with renal allograft in the perioperative period and 2 patients with AR more than 1 year after surgery were enrolled. Blood samples were taken weekly according to the different conditions of the patients. Serum sPTA1 level was measured by sandwich ELISA. Flow cytometry To detect the expression of mPTA1 in lymphocytes, pathological examination of transplanted renal biopsy was performed in patients with definite rejection, suspicious rejection and indistinguishable rejection. Results: Preoperative sPTA1 levels and mPTA1 expression no significant difference with the control (P> 0.05). On the first postoperative day, sPTA1 had a high level of expression, which was significantly different from the control group (P <0.05). Among the 19 patients with pathologically confirmed renal allograft, the sPTA1 expression was significantly increased and the expression of mPTA1 was enhanced in the 5 patients with pathologically confirmed rejection, which was significantly different from the control group (P <0.01). After hormone shock treatment, serum sPTA1 decreased, mPTA1 expression decreased. And sPTA1 levels change earlier than the clinical manifestations of AR, the longer duration. Conclusion: PTA1 can be used as an indicator of early warning and monitoring of AR and has good consistency with the results of pathological examination. PTA1 level changes earlier than clinical manifestations and pathological changes