摘要
目的 探讨肾移植术后早期巨细胞病毒 (CMV)感染与慢性移植物肾病 (CAN)的关系。 方法 1999年 8月至 2 0 0 0年 12月行肾移植并随访 3年的患者 77例 ,根据术后 6个月内外周血CMV pp6 5 ( + )白细胞计数的数量和持续时间 ,将其分为 :非活动性 (A组 ,n =15 )、低活动性 (B组 ,n=32 )、短期高活动性 (C组 ,n =18)和长期高活动性 (D组 ,n =12 )CMV感染 4组。 6个月后行移植肾穿剌活检 ,通过免疫荧光和逆转录聚合酶链反应 (RT PCR)比较 4组患者肾组织中转移生长因子β1(TGF β1)蛋白和mRNA的表达量 ;3年后比较 4组患者肾功能不全 (血肌酐持续 >114 μmol/L)的发生率和肌酐清除率 (Ccr)减损量 ;对肾功能不全的患者通过活检明确是否为CAN。 结果 肾移植 6个月后A、B、C组TGF β1蛋白表达量分别为 :( 5 .82± 1.32 )× 10 6、( 6 .34± 1.4 7)× 10 6和 ( 6 .5 8± 1.4 4 )× 10 6,TGF β1mRNA分别为 :0 .84± 0 .17、0 .78± 0 .15和 0 .82± 0 .16 ;D组TGF β1蛋白和mRNA表达量分别为 ( 10 .4 7± 2 .12 )× 10 6和 1.37± 0 .2 5 ,均明显高于前 3组 (P <0 .0 1)。前 3组 3年内Ccr减损量分别为 :( 5 .6± 5 .2 )、( 6 .2± 6 .4 )和 ( 5 .9± 4 .7)ml/min ;D组为 ( 15 .8± 9.6 )ml/min ,明显高于前
Objective To investigate the association between active cytomegalovirus (CMV) infections in early stage of posttransplantation and chronic allograft nephropathy (CAN). Methods From August,1999 to December,2000,according to the count of CMV-pp65-positive leukocytes in peripheral blood within 6 months after transplantation, 157 patients undergoing renal transplantation were divided into 4 groups. They were Groups A (non-active-CMV-infection),B (mild active-CMV-infection),C (severe active-CMV-infection with short duration) and D (severe active-CMV-infection with long duration).Six months after renal transplantation,biopsies were carried out, and expressions of TGF-β 1 protein and mRNA in the allografts were compared among the 4 groups.Three years later, the incidence of renal dysfunction (blood creatinine >114 μmol/L continuously) and loss of creatinine clearance (Ccr) were also compared among the 4 groups.For patients with renal dysfunction,the renal biopsies were used to determine whether they had CAN. Results Seventy-seven patients were followed up for 3 years,and their data were analyzed.There were 15 cases in Group A,32 in Group B,18 in Group C,and 12 in Group D.In Groups A,B and C,the expressions of TGF-β 1 protein in the allografts at 7 months after transplantation were (5.82±1.32)×10 6,(6.34± 1.47 )×10 6 and (6.58±1.44)×10 6,and the expressions of TGF-β 1 mRNA were 0.84±0.17,0.78± 0.15 and 0.82±0.16,respectively.In Group D the expressions of TGF-β 1 protein and mRNA were (10.47± 2.12 )×10 6 and 1.37±0.25,which were significantly greater than those in Groups A,B and C ( P < 0.01 ).During the 3-year study period,in Group D,the loss of Ccr was (15.8±9.6)ml/min,which was significantly greater than those in Groups A,B and C.[(5.6±5.2),(6.2±6.4) and (5.9±4.7)ml/min].The incidence of renal dysfunction in Groups A,B and C was 6.7%(1/15),9.4%(3/32) and 5.6%(1/18),respectively;while that in Group D was 50.0%(6/12),which was significantly higher than those in Groups A,B and
出处
《中华泌尿外科杂志》
CAS
CSCD
北大核心
2004年第11期734-738,共5页
Chinese Journal of Urology
