南方医科大学学报 ›› 2006, Vol. 26 ›› Issue (09): 1352-1355.

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转化生长因子β1对远期移植肾功能影响的临床观察

王平贤; 范明齐; 黄赤兵; 张艮甫;   

  1. 第三军医大学新桥医院泌尿外科; 第三军医大学新桥医院泌尿外科 重庆400037; 重庆400037;
  • 出版日期:2006-09-20 发布日期:2006-09-20

Influence of transforming growth factor β1 on long-term renal allograft function

WANG Ping-xian, FAN Ming-qi, HUANG Chi-bing, ZHNAG Gen-fu Department of Urologic Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, China   

  1. 第三军医大学新桥医院泌尿外科; 第三军医大学新桥医院泌尿外科 重庆400037; 重庆400037;
  • Online:2006-09-20 Published:2006-09-20

摘要: 目的探讨肾移植受者转化生长因子β1(TGF-β1)与远期移植肾功能的关系。方法1999年8月 ̄2001年6月期间对肾移植术后满1年、肾功能正常的患者检测血、尿TGF-β1浓度,并对上述患者进行3年以上的前瞻性观察,对观察期内肾功不全的患者明确是否为慢性移植肾肾病(CAN)。3年后共有134例患者完成了全程随访,根据术后1年时尿TGF-β1不同的浓度,比较其在3年观察期内肌酐清除率(Ccr)损失量有无差异;其中有16例诊断为CAN的患者,比较CAN患者与非CAN患者在肾移植1年时的血、尿TGF-β1等有无差异。结果上述134例患者术后1年时尿TGF-β1浓度为:135.6 ̄442.3pg/mg·Cr;尿TGF-β1浓度高的患者在3年观察期内Ccr损失量明显大于尿TGF-β1浓度低的患者;非CAN与CAN患者在肾移植1年时,尿TGF-β1相对浓度分别为(182.7±40.2)和(398±33.5)pg/mg·Cr(P<0.01),血TGF-β1浓度分别为(32.1±4.7)和(31.9±4.8)ng/ml(P>0.05)。结论TGF-β1可能在CAN的发生过程中起着重要作用,CAN患者在肾功能异常前尿TGF-β1已显著升高,肾移植后早期检测尿TGF-β1对远期肾功能具有一定的预测作用。

Abstract: Objective To determine the association between urine transforming growth factor β1 (TGF-β1) concentration and long-term renal allograft function. Methods Patients undergoing kidney transplantation between August 1, 1999 and June 30, 2001 and survived for one year with normal renal functions were investigated. The blood and urine TGF-β1 concentrations were tested at an interval of at least 6 months. Totally 134 patients completed the 3-year follow up investigation. Correlation between their renal functions (creatinine clearance rates) and their urine relative TGF-β1 concentrations 1 year after renal transplantation were determined. Of the 134 renal recipients, 16 were diagnosed to have chronic allograft nephropathy (CAN), and their blood and urine TGF-β1 concentrations 1 year after renal transplantation were compared with those of the recipients free of CAN. Results There was a positive correlation between long-term renal functions (loss of creatinine clearance rates) and in relative concentration of TGF-β1 urine 1 year after renal transplantation. The urine TGF-β1 concentrations of CAN and CAN-free recipients 1 year after transplantation were 182.7±40.2 and 398±33.5 pg/mg·Cr, respectively, showing significant differences. The blood TGF-β1 concentrations of CAN and CAN-free recipients were comparable (32.1±4.7 and 31.9±4.8 ng/ml, respectively). Conclusion Urine TGF-β1 is significantly elevated even before the onset of renal dysfunction in patients with CAN, and urine TGF-β1 level in early stage after renal transplantation can help predict long-term renal function. 

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