摘要：目的：急性排异是肾移植术后常见并发症。血管细胞粘附分子1（Vascular cell adhesion molecule 1，VCAM1）可能与移植后急性排异（acute rejection，AR）相关。本研究旨在阐述VCAM1 基因rs2392221单核苷酸多态性（single nucleotide polymorphisms，SNP）与肾移植后急性排异发生的相关性。方法：采用回顾性分析方法，回顾我院200例肾移植患者，根据肾移植术后是否发生急性排异分为非AR组131例和AR组69例。通过二代测序对VCAM1 rs2392221基因型进行检测。采用5个遗传模型分析VCAM1 rs2392221对AR的影响。结合临床和人口统计学数据，评估VCAM1 rs2392221基因多态性与肾移植术后急性排异的关联。结果：4个遗传模型研究显示VCAM1 rs2392221与肾移植术后急性排异显著相关（codominant model (OR1=3.71, 95% CI1:1.82-7.58, OR2=5.41, 95% CI2: 1.14-25.75,P=0.00051; dominant model (OR=3.9, 95% CI: 1.97-7.72),P=0.00068; recessive model (OR=3.57, 95% CI: 0.77-16.54),P=0.357; over-dominant model (OR=3.31, 95% CI: 1.65-6.65), P=0.0015; log-additive model (OR=3.04, 95% CI: 1.7-5.43),P=0.0344)）。结论：VCAM1 rs2392221与肾移植术后急性排异的发生显著相关，检测VCAM1 rs2392221可能有助于早期诊断急性排异的发生。
Abstract：Objective: Acute rejection（AR）is a common complication of kidney transplantation. VCAM1 has been observed to be involved in AR. Our study aims to investigate the correlations between single nucleotide polymorphism rs2392221 in VCAM1 and the risk of AR in renal transplant recipients. Methods: 200 Chinese renal transplant recipients were enrolled and divided into non-AR group(n=131 cases) and AR group(n=69 cases). The VCAM1 rs2392221 genotypes were detected by next generation sequencing. 5 adjusted inheritance models were utilized to investigate the influence of VCAM1 rs2392221 on AR. Combining clinical and demographic data, the association between VCAM1 rs2392221 gene polymorphisms and AR in renal transplant recipients was evaluated. Results: The SNP rs2392221 on VCAM1 gene exhibited significant correlation with the occurrence of AR in four of the five models as P=0.00051 in codominant model (OR1=3.71, 95% CI1:1.82-7.58, OR2=5.41, 95% CI2: 1.14-25.75), P=0.00068 in dominant model (OR=3.9, 95% CI: 1.97-7.72), P=0.357 in recessive model (OR=3.57, 95% CI: 0.77-16.54), P=0.0015 in over-dominant model (OR=3.31, 95% CI: 1.65-6.65), P=0.0344 in log-additive model (OR=3.04, 95% CI: 1.7-5.43)). Conclusion: In this study, we observed that SNP , rs2392221, was significantly related to the occurrence of AR in Chinese renal transplant recipients ,thereby indicating a potential target for the early diagnosis of AR.