可溶性C5b-9在肾移植术后移植物功能延迟恢复诊断中的应用价值

Application value of soluble C5b-9 in the diagnosis of delayed graft function after kidney transplantation

    摘要
  • 摘要:
    目的 探讨可溶性C5b-9（sC5b-9）在诊断肾移植术后移植物功能延迟恢复（DGF）的价值。
    方法 回顾性分析2024年1月至2025年12月在山西省第二人民医院接受sC5b-9检测的49例肾移植受者的资料。根据DGF发生情况，分为DGF组（25例）和Non-DGF组（24例）。对比两组受者一般资料及sC5b-9水平，采用受试者工作特征（ROC）曲线分析sC5b-9诊断DGF的性能。使用限制性立方样条模型探讨sC5b-9与DGF的关系。
    结果 49例肾移植受者中，25例发生了DGF。与Non-DGF组比较，DGF组男性占比较高，发生不良移植结局的比例较高，末次血清肌酐水平较高（均为P<0.05）。与Non-DGF组比较，DGF组术后30 d内sC5b-9水平较高（P<0.001）。ROC曲线分析显示，sC5b-9诊断DGF的曲线下面积（AUC）为0.81，95%可信区间（CI）0.68~0.92，最佳截断值为265.7 ng/mL。sC5b-9水平较高（≥265.7 ng/mL）的患者DGF发生率高于sC5b-9水平较低（<265.7 ng/mL）的患者（P<0.001）。发生不良结局受者的sC5b-9水平高于未发生受者（P<0.001），sC5b-9区分不良结局的AUC值为0.82（95%CI 0.63~0.95）。sC5b-9与末次血清肌酐存在非线性关系（P<0.001）。
    结论 sC5b-9水平升高与肾移植术后DGF的发生相关，具有良好的诊断性能，可能成为预测肾移植受者早期移植物功能障碍及不良结局的潜在生物标志物。

     

    Abstract:
    Objective To explore the diagnostic value of soluble C5b-9 (sC5b-9) for delayed graft function (DGF) following kidney transplantation.
    Methods Clinical data of 49 kidney transplant recipients who underwent sC5b-9 detection at the Second People’s Hospital of Shanxi Province between January 2024 and December 2025 were retrospectively analyzed. Recipients were divided into the DGF group (n=25) and the non-DGF group (n=24) according to the occurrence of DGF. Baseline characteristics and serum sC5b-9 levels were compared between the two groups. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of sC5b-9 for DGF. A restricted cubic spline model was adopted to investigate the association between sC5b-9 and DGF.
    Results Among the 49 recipients, DGF occurred in 25 patients. Compared with the non-DGF group, the DGF group presented a higher proportion of male patients, a higher incidence of adverse transplant outcomes, and elevated final serum creatinine levels (all P<0.05). Within 30 days after transplantation, sC5b-9 concentrations were significantly higher in the DGF group than those in the non-DGF group (P<0.001). ROC analysis revealed that the area under the curve (AUC) of sC5b-9 for diagnosing DGF was 0.81, with a 95% confidence interval (CI) of 0.68-0.92, and the optimal cutoff value was 265.7 ng/mL. Recipients with elevated sC5b-9 (≥265.7 ng/mL) had a significantly higher incidence of DGF than those with low sC5b-9 levels (<265.7 ng/mL) (P<0.001). Recipients with adverse outcomes exhibited significantly higher sC5b-9 levels than those without adverse outcomes (P<0.001), and the AUC of sC5b-9 for identifying adverse outcomes was 0.82 (95%CI 0.63-0.95). A significant nonlinear correlation was observed between sC5b-9 and final serum creatinine (P<0.001).
    Conclusions Elevated sC5b-9 is correlated with the development of DGF after kidney transplantation and exhibits favorable diagnostic performance. It may serve as a potential biomarker for predicting early allograft dysfunction and adverse outcomes in kidney transplant recipients.

     

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