对162次肾移植病例的临床过程及实验室资料加以仔细复习,尤其对过去报道之急性排斥的典型症状加以重点注意。这些症状包括发热、尿排出减少、血压升高、移植肾的压痛、尿钠浓度降低及白细胞计数改变等。 162次肾移植中有20例22次在移植后8个月至5年发生肾功能恶化,当时从实验室及临床推测其原因可能为急性排斥反应,19次经皮肾活检证实为急性排斥,另3例未作活检,而是从抗排斥的治疗反应作出诊断。活检标本均示有排斥存在,如间质水肿与浸润、肾小球炎及动脉炎。 22例次中,13例次(59%)发生排斥时无任何典型症状和体征,7例次(32%)唯一症状为血压升 The clinical course and laboratory data of 162 renal transplant cases were carefully reviewed, with particular attention paid to the typical symptoms of acute rejection reported in the past. These symptoms include fever, decreased urinary excretion, elevated blood pressure, tenderness in the kidneys, decreased urinary sodium concentration and changes in white blood cell count. Of 162 162 renal transplantations, 22 developed renal dysfunction 22 months to 8 years posttransplant. At that time, it was speculated from laboratory and clinical studies that the reason for this may be acute rejection and 19 percutaneous renal biopsy confirmed acute rejection. The other 3 patients did not undergo biopsy, but diagnosed their anti-rejection response. Biopsy specimens showed the existence of exclusion, such as interstitial edema and infiltration, glomerular inflammation and arteritis. Among the 22 cases, 13 cases (59%) had no typical symptoms and signs of rejection, and the only symptom of 7 cases (32%) was blood pressure