论文部分内容阅读
目的:探讨CD20+细胞在移植肾排斥反应中浸润程度与移植肾预后的关系。方法:选取93例肾移植后穿刺患者,肾活检组织标本行CD20免疫组化染色。并对病理结果行半定量分析,根据CD20+细胞在肾组织内浸润程度,分为阴性组48例(N组,CD20+细胞浸润占肾小管间质面积<10%)、中度浸润组25例(M组,CD20+细胞浸润占肾小管间质面积≥10%<50%)和重度浸润组20例(H组,CD20+细胞浸润占肾小管间质面积≥50%)。分析CD20+细胞浸润的程度与移植肾预后的相关性。随访内容包括患者穿刺活检后的临床资料,随访内容包括患者的肌酐、蛋白尿变化及移植肾的生存状况等指标。结果:三组患者在年龄、性别、组织活检时间以及移植的次数均没有明显差异(P>0.05);穿刺活检后12个月的肌酐N组[(276.79±240.78)μmol/L]低于M组[(360.16±290.30)μmol/L];M组低于H组[(466.50±330.53)μmol/L],P<0.05;CD20+浸润组的患者的4年生存率明显低于阴性组(P<0.05);穿刺活检后12个月内,N组穿刺后出现蛋白尿的概率明显低于M组和H组(P<0.05)。结论:CD20+细胞在肾移植内浸润的程度与移植肾预后有明显相关性。
Objective: To investigate the relationship between the infiltration of CD20 + cells in renal allograft rejection and the prognosis of renal allograft. Methods: Ninety-three patients who underwent transplanted renal transplantation were enrolled. The renal biopsy specimens were stained with CD20 immunohistochemistry. According to the degree of infiltration of CD20 + cells in renal tissue, 48 cases were divided into negative group (N group, CD20 + cell infiltration accounted for <10% of tubulointerstitial area), moderate infiltration group (25 cases M group, CD20 + cell infiltration accounted for more than 10% of tubulointerstitial area <50%) and severe infiltration group (H group, CD20 + cell infiltration accounted for tubulointerstitial area 50%). The correlation between the degree of CD20 + cell infiltration and the prognosis of renal allograft was analyzed. The follow-up included the clinical data of patients after biopsy, follow-up included creatinine, proteinuria, and the survival status of the grafted kidney. Results: There was no significant difference in the age, sex, time of biopsy and the number of transplants between the three groups (P> 0.05); creatinine N group (276.79 ± 240.78) μmol / L at 12 months after biopsy was lower than M Group ([360.16 ± 290.30] μmol / L]; M group was lower than that of H group [(466.50 ± 330.53) μmol / L], P <0.05; 4-year survival rate of patients in CD20 + <0.05). Within 12 months after biopsy, the probability of proteinuria after puncture in group N was significantly lower than that in group M and group H (P <0.05). Conclusion: The degree of infiltration of CD20 + cells in renal transplantation is significantly correlated with the prognosis of renal allograft.