摘要
目的 探讨血小板相关参数与肾移植后发生早期急性排斥反应（AR）的关系.方法 选取山西省第二人民医院2015年10月至2017年6月间收治的肾脏衰竭行异体肾移植的患者112例为研究对象,根据是否发生AR进行分组,发生AR为观察组（23例）,未出现AR为对照组（89例）,分析两组患者术前（T0）、术后5 d（T1）、术后10 d（T2）、术后15 d（T3）、术后30 d（T4）血小板参数[外周血血小板计数（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）、大型血小板比值（P-LCR）]的差异,并分析PLT、PCT、MPV、PDW、P-LCR与肾移植术后急性排斥反应的相关性.结果 与术前对比,术后两组患者PLT[（122.06±49.67）×10^9/L比（185.26±63.49）×10^9/L）]、PCT[（0.46±0.28）％比（0.34±0.06）％）]于T1、T2处出现下降（P＜0.05）;术后两组患者MPV、PDW、P-LCR均升高（均P＜0.05）,T1、T2基线处对比,观察组MPV[（13.69±0.59）比（12.24±0.42）、（16.08±0.61）比（12.52±0.57）]、PDW[（13.26±1.19）比（12.13±2.14）、（15.46±3.15）比（12.72±2.09）]、P-LCR[（30.57±7.29）比（28.13±6.34）、（33.01 ±3.98）比（29.13±6.91）]均高于对照组（均P＜0.05）.相关性分析显示：MPV、PDW、P-LCR水平与肾移植术后急性排斥反应的发生均呈正相关（r =0.464、0.606、0.512,均P＜0.05）,而PLT、PCT与肾移植术后急性排斥反应的发生无关.结论 MPV、PDW、P-LCR可间接反应肾移植术后AR的发生,术后监测MPV、PDW、P-LCR三项指标的变化趋势为术后AR发生的辅助诊断手段.
Objective To investigate the relationship between primary platelet parameters and early acute rejection （AR） after renal transplantation.Methods From October 2015 to June 2017,112 patients with renal failure underwent allograft renal transplantation in the Second People＇s Hospital of Shanxi Province were selected as the research objects,according to the preoperative and postoperative 30d in platelet parameters based on the occurrence of AR they were classified into the observation group （23 cases）,no rejection for the control group （89 cases）,analysis the difference of two groups of patients with platelet parameters [peripheral blood platelet count （PLT）,platelet hematocrit （PCT）,mean platelet volume （MPV） and platelet volume distribution width （PDW）,the ratio of large platelet （P-LCR）] at preoperative （T0）,postoperative 5 d （T1）,10 d （T2） after operation,postoperative 15 d （T3） 15,30 d （T4）.The correlation between PLT,PCT,MPV,PDW,P-LCR and acute rejection after renal transplantation was also analyzed.Results Compared with those of preoperative,the PLT [（122.06 ± 49.67） × 10^9/L vs.（185.26 ± 63.49） × 10^9/L）],PCT[（0.46 ± 0.28） % vs.（0.34 ± 0.06） %）] in T1,T2 of the two group after surgery declined （P 〈 0.05）.MPV,PDW and P-LCR were increased in both groups after surgery （P 〈0.05）,and the observation group were higher than that in the control group MPV[（13.69 ± 0.59） vs.（12.24 ±0.42）,（16.08 ±0.61） vs.（12.52 ±0.57）],PDW[（13.26 ± 1.19） vs.（12.13 ±2.14）,（15.46±3.15） vs.（12.72 ±2.09）],P-LCR[（30.57 ±7.29） vs.（28.13 ±6.34）,（33.01 ±3.98） vs.（29.13 ± 6.91）] at the baseline of T1 and T2 （all P 〈 0.05）.Correlation analysis showed that the level of MPV,PDW,P-LCR and the occurrence of acute rejection after kidney transplantation were positively correlated （r =0.464,0.606,0.512,all P 〈0.05）,while the PLT,PCT has nothing to do with the occurrence of acute rejection after kidney transplantation.Conclusion MPV,PDW and P-LCR can indirectly reflect the occurrence of AR after renal transplantation,and the trend of monitoring the three indexes of MPV,PDW and P-LCR after operation is an auxiliary diagnostic method for postoperative AR.
作者
孙永康
Sun Yongkang(Department of Kidney Transplantation Dialysis Center,the Second People＇s Hospital of Shanxi Province,Taiyuan,Shanxi 030012,China)
出处
《中国基层医药》
CAS
2018年第16期2070-2073,共4页
Chinese Journal of Primary Medicine and Pharmacy
关键词
肾移植
肾功能衰竭
慢性
血小板
移植物排斥
Kidney transplantation
Kidney failure,chronic
Blood platelets
Graft rejection
