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目的探讨肾移植受者术后机体内肿瘤坏死因子（ＴＮＦ）水平的变化及其临床意义。方法采用酶联免疫双抗体夹心法（ＥＬＩＳＡ）动态监测２３例肾移植受者术后血浆ＴＮＦα的浓度。结果急性排斥反应组ＴＮＦα比术后稳定组显著升高（Ｐ＜０．０１），且较临床表现和血清肌酐的升高提前１～２ｄ；而环孢霉素Ａ肾中毒及急性肾小管坏死的ＴＮＦα水平变化不明显；排斥者在应用甲基强的松龙／ＡＴＧ冲击有效时ＴＮＦα水平逐渐下降。结论血浆ＴＮＦα的测定可作为移植肾急性排斥反应诊断和鉴别诊断的重要免疫学指标。
Objective To investigate the changes of tumor necrosis factor (TNF) level and its clinical significance in renal transplant recipients. Methods Serum TNFα levels were measured by enzyme-linked immunosorbent assay (ELISA) in 23 renal transplant recipients. Results The level of TNFα in acute rejection group was significantly higher than that in stable group (P <0.01), and the level of TNFα was 1 ~ 2 days earlier than that of clinical manifestations and serum creatinine. Cyclosporine A nephrotoxicity and acute tubular necrosis TNFα levels did not change significantly; rejection in patients with methylprednisolone / ATG impact effective TNFα levels decreased. Conclusion The determination of plasma TNFα can be used as an important immunological indicator in the diagnosis and differential diagnosis of acute rejection of renal allografts.