南方医科大学学报 ›› 2015, Vol. 35 ›› Issue (03): 413-.

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血小板参数与肾移植术后急性排斥反应的关系

付绍杰,梁永杰,于立新,罗敏,王亦斌,杜传福,叶俊生,肖露露   

  • 出版日期:2015-03-20 发布日期:2015-03-20

The correlation between platelet parameters and acute rejection after renal
transplantation

  • Online:2015-03-20 Published:2015-03-20

摘要: 目的探讨血小板计数(PLT)、血小板比容(PCT)、平均血小板体积(MPV)、血小板体积分布宽度(PDW)、大血小板比率
(P-LCR)五项参数与肾移植术后早期急性排斥反应(AR)的关系。方法回顾分析167例肾移植受者术后2个月内血小板五项
参数的动态变化。以同期发生AR的35例受者为观察组,移植肾功能恢复良好的132例受者为对照组,检测术前及术后1~10、
15、30、45、60 d血小板五项参数,进行统计学分析。结果AR组与对照组比较:术前PLT、PCT、MPV、P-LCR两组均数无统计学
差异(P>0.05),AR组术前PDW数值明显高于对照组(t=2.18, P=0.035)。术后第1~5 天两组血小板5 项参数均无统计学差异
(P>0.05),但术后第6~15 天AR组中MPV、PDW、P-LCR三项指标明显高于对照组(P<0.05)。并且,AR组受者术后第6~9 天
MPV、PDW、P-LCR三项指标数值基本呈平稳趋势,而对照组则呈下降趋势,两组变化存在明显差异(P<0.05)。结论肾移植受
者术前PDW数值可能与术后AR的发生呈正相关;术后监测MPV、PDW、P-LCR三项指标的变化趋势,可作为诊断AR发生的
一种辅助方法。

Abstract: Objective To investigate the relationship between acute graft rejection early after renal transplantation and the
variations of platelet parameters. Methods We retrospectively analyzed the clinical data of 167 renal transplant recipients
before and within 2 months after the surgery. Before and at 1-10 days, 15 days, 30 days, 45 days and 60 days after the
transplantation, 5 platelet parameters, including platelet count (PLT), platelet hematocrit (PCT), mean platelet volume (MPV),
platelet volume distribution width (PDW), and large platelet ratio (P-LCR), were detected in the 35 patients with acute graft
rejection within two months (AR group) and in the other 132 recipients with good graft recovery (control group). Results The
AR group and control group showed no significant difference in PLT, PCT, MPV, or P-LCR before the surgery, but the PDW
was significantly higher in the AR group (t=2.18, P=0.035). These parameters were similar within 5 postoperative days between
the two groups (P>0.05), but in postoperative days 6-15, the AR group showed significantly increased MPV, PDW and P-LCR
compared with the control group (P<0.05). In postoperative days 6-9, MPV, PDW and P-LCR became stable in AR group but
tended to decrease in the control group, showing obviously different patterns of variation between the two groups (P<0.05).
Conclusions Preoperative PDW may have a positive correlation with acute graft rejection after renal transplantation.
Monitoring the variations of MPV, PDW and P-LCR may help in the diagnosis of acute graft rejection early after renal
transplantation.