Taylor J E, Scott N, Hill A, Bridges A, Henderson I S, Stewart W K, Belch J J
Renal Unit, Ninewells Hospital and Medical School, Dundee, Scotland.
Transplantation. 1993 Mar;55(3):500-4. doi: 10.1097/00007890-199303000-00009.
Oxygen free radical reaction products (plasma malondialdehyde), the free radical scavengers plasma thiol and red cell superoxide dismutase (SOD), and whole blood platelet and granulocyte aggregation were measured in 23 renal transplant patients and 23 age-matched controls. Malondialdehyde-like material (MDA) was significantly increased in transplant patients compared with controls (transplants MDA [median, range], 7.7 [5.3-11.5] nmol/ml; controls MDA, 6.3 [5.4-8.7] nmol/ml; P < 0.001). The patients also had increased red cell superoxide dismutase (transplants SOD, 128.1 [89.4-93.8] U/0.5 ml red cells; controls SOD, 95.9 [62.0-132.6] U/0.5 ml red cells; P < 0.001) and reduced plasma thiol (transplants thiol, 428 [266-496] mumol/L; controls thiol, 445 [358-501] mumol/L; P < 0.05). These factors were not influenced by immunosuppressive therapy, duration of transplantation, or creatinine concentration. Transplant patients had significantly higher levels of collagen-induced and spontaneous whole blood platelet aggregation compared with controls (collagen: transplants, 72 [4-93%]; controls 43 [6-94]%; P < 0.001; spontaneous: transplants 46 [11-93]%; controls 37 [10-75]%; P < 0.05). Spontaneous platelet aggregation, however, was significantly correlated with creatinine concentration (r = 0.525, P < 0.02, Spearman's correlation), and was raised only in those patients with a degree of renal impairment. Granulocyte aggregation was increased in patients receiving cyclosporine (CsA [n = 15], 57 [36-66]%; no cyclosporine [n = 8], 45 [37-62]%; controls [n = 23]; 39 [31-61]%; P = 0.004). Renal transplant patients are subject to oxidative cell damage, and may be at increased risk of vascular thrombosis. Possible contributory factors include an immunological reaction to the graft and/or the effects of immunosuppressive therapy.
对23例肾移植患者和23例年龄匹配的对照者测定了氧自由基反应产物（血浆丙二醛）、自由基清除剂血浆硫醇和红细胞超氧化物歧化酶（SOD），以及全血血小板和粒细胞聚集情况。与对照组相比，移植患者的丙二醛样物质（MDA）显著增加（移植组MDA[中位数，范围]，7.7[5.3 - 11.5]nmol/ml；对照组MDA，6.3[5.4 - 8.7]nmol/ml；P<0.001）。患者的红细胞超氧化物歧化酶也升高（移植组SOD，128.1[89.4 - 93.8]U/0.5ml红细胞；对照组SOD，95.9[62.0 - 132.6]U/0.5ml红细胞；P<0.001），而血浆硫醇降低（移植组硫醇，428[266 - 496]μmol/L；对照组硫醇，445[358 - 501]μmol/L；P<0.05）。这些因素不受免疫抑制治疗、移植持续时间或肌酐浓度的影响。与对照组相比，移植患者胶原诱导的和自发性全血血小板聚集水平显著更高（胶原：移植组，72[4 - 93%]；对照组43[6 - 94]%；P<0.001；自发性：移植组46[11 - 93]%；对照组37[10 - 75]%；P<0.05）。然而，自发性血小板聚集与肌酐浓度显著相关（r = 0.525，P<0.02，Spearman相关性），且仅在有一定程度肾功能损害的患者中升高。接受环孢素（CsA）治疗的患者（n = 15）粒细胞聚集增加（57[36 - 66]%），未接受环孢素治疗的患者（n = 8）为45[37 - 62]%，对照组（n = 23）为39[31 - 61]%；P = 0.004）。肾移植患者易发生氧化细胞损伤，血管血栓形成风险可能增加。可能的促成因素包括对移植物的免疫反应和/或免疫抑制治疗的影响。
