Ortuño J, González-Revalderia J, Teruel J L, Villafruella J J, Sabater J, Matesanz R, Quereda C
Servicio de Nefrologia, Hospital Ramon Y Cajal, Madrid, Spain.
Nephrol Dial Transplant. 1988;3(3):305-11.
To establish whether or not urinary excretion TxB2 is a useful parameter in the diagnosis of acute renal rejection, 45 renal transplant patients were studied and classified in four groups: Group A. Ten observations of satisfactory clinical outcome (without either acute rejection or tubular necrosis). Urinary TxB2 was initially increased but had settled to normal by the 3rd postoperative day. Two patients had subsequent increases. Group B. Twenty-five episodes of acute rejection on a previously satisfactorily functioning graft. Nineteen had increases in TxB2 values before serum creatinine increased. Group C. Five episodes of tubular necrosis without acute rejection. The evolution was similar to Group A. Group D. Nine acute episodes of rejection on kidneys with tubular necrosis. The urinary output of TxB2 was increased from the beginning. This increase was maintained until the rejection was treated. This group had the highest values of urine TxB2. The principal significance of this parameter lies in its precocity and in its utility for diagnosis of acute rejection in the graft with tubular necrosis, as the persistence of raised values of TxB2 in the urine beyond the 3rd postoperative day is highly suggestive of an acute rejection.
为了确定尿排泄血栓素B2（TxB2）是否为诊断急性肾移植排斥反应的有用参数，对45例肾移植患者进行了研究，并将其分为四组：A组。10例临床结局良好（无急性排斥反应或肾小管坏死）。尿TxB2最初升高，但术后第3天恢复正常。2例患者随后出现升高。B组。25例先前功能良好的移植肾发生急性排斥反应。19例在血清肌酐升高之前TxB2值升高。C组。5例无急性排斥反应的肾小管坏死。其演变过程与A组相似。D组。9例伴有肾小管坏死的肾脏发生急性排斥反应。TxB2的尿量从一开始就增加。这种增加一直持续到排斥反应得到治疗。该组的尿TxB2值最高。该参数的主要意义在于其早熟性以及对伴有肾小管坏死的移植肾急性排斥反应诊断的实用性，因为术后第3天以后尿中TxB2值持续升高高度提示急性排斥反应。
