Peng W, Chen J, Jiang Y, Shou Z, Chen Y, Wang H
Department of Nephrology, The First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, China.
J Int Med Res. 2007 Jul-Aug;35(4):442-9. doi: 10.1177/147323000703500402.
Urinary vascular endothelial growth factor (VEGF) was determined by enzyme-linked immunosorbent assay in 199 renal allograft recipients and 80 healthy controls. Urinary VEGF level did not change significantly during the first 8 weeks after transplantation in 119 patients with stable renal function and there were no abnormal histological findings (No-AR). In 67 patients with acute rejection, urinary VEGF was significantly higher (28.57 +/- 6.21 pg/micromol creatinine) than in the No-AR patients (3.05 +/- 0.45 pg/micromol creatinine) and healthy controls (2.87 +/- 0.35 pg/micromol creatinine). At a cut-off point of 3.26 pg/micromol creatinine, sensitivity and specificity for diagnosis of acute rejection were 86.6 and 71.4%, respectively. The 13 patients with subclinical rejection excreted urinary VEGF (16.14 +/- 4.09 pg/micromol creatinine) at a significantly higher level than No-AR patients (3.05 +/- 0.45 pg/micromol creatinine). At a cut-off point of 4.69 pg/micromol creatinine, sensitivity and specificity for diagnosis of subclinical rejection were 84.6 and 79.8%, respectively. In conclusion, monitoring VEGF in urine might offer a new non-invasive way to detect acute and subclinical rejection in renal transplant recipients.
采用酶联免疫吸附测定法检测了199例肾移植受者和80例健康对照者的尿血管内皮生长因子（VEGF）。119例肾功能稳定且组织学检查无异常发现（无急性排斥反应）的患者在移植后的前8周内尿VEGF水平无显著变化。67例发生急性排斥反应的患者尿VEGF水平（28.57±6.21 pg/微摩尔肌酐）显著高于无急性排斥反应患者（3.05±0.45 pg/微摩尔肌酐）和健康对照者（2.87±0.35 pg/微摩尔肌酐）。以3.26 pg/微摩尔肌酐为临界值，诊断急性排斥反应的敏感性和特异性分别为86.6%和71.4%。13例亚临床排斥反应患者尿VEGF排泄量（16.14±4.09 pg/微摩尔肌酐）显著高于无急性排斥反应患者（3.05±0.45 pg/微摩尔肌酐）。以4.69 pg/微摩尔肌酐为临界值，诊断亚临床排斥反应的敏感性和特异性分别为84.6%和79.8%。总之，监测尿VEGF可能为检测肾移植受者的急性和亚临床排斥反应提供一种新的非侵入性方法。
