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排斥反应是同种异体肾移植术后的重要问题之一。临床上探索诸多方法监测,由于标本大多来自外周血或尿液等,仍难以早期准确诊断和及时处理。移植肾经皮穿刺肾活体病理组织检查准确可靠,但系创伤检测,可有血尿、肾周血肿乃至肾破裂等危及生命风险,似不宜作为常规监测手段。近十年来,以芬兰赫尔辛基医学院为首的许多肾移植中心,采用细针抽吸活检(FNAB)的方法诊断和监测肾移植急性排斥反应,取得良好效果,一致认为FNAB是一种安全、可依、可重复的监测手段,国外临床上亦广泛采用。本文简扼介绍FNAB方法及临床应用。
Rejection is one of the important problems after allogeneic kidney transplantation. Many ways to explore clinical monitoring, as most of the specimens from peripheral blood or urine, it is still difficult to early accurate diagnosis and timely treatment. Transplant renal percutaneous renal biopsy is accurate and reliable, but the Department of trauma testing, may have hematuria, perirenal hematoma and renal rupture and other life-threatening risks, it seems inappropriate as a routine monitoring tool. In the past decade, many kidney transplant centers led by the Helsinki School of Medicine in Finland have used fine needle aspiration biopsy (FNAB) to diagnose and monitor the acute rejection of renal allograft and achieved good results. They agree that FNAB is safe, , Repeatable monitoring methods, is widely used clinically abroad. This article briefly describes the FNAB method and clinical application.