肝移植术后患者外周血 CD4＋T 细胞内 ATP 与T 细胞亚群联合检测对免疫功能的监测作用

摘要

目的：探讨肝移植术后患者外周血CD4＋T淋巴细胞内ATP水平和T细胞亚群联合检测对免疫功能的监测作用。方法选择肝移植术后患者80例，其中术后病情稳定30例（稳定组）、出现感染30例（感染组），发生急性排异反应20例（排异组），另选健康体检者30例作为对照组。采用Cylex＋ImmuKnow方法检测CD4＋T淋巴细胞内ATP，流式细胞术检测T细胞亚群，比较各组ATP及T细胞亚群的变化情况，分析二者的相关性。结果感染组ATP明显低于稳定组和对照组，排异组ATP明显高于稳定组和对照组（P均＜0．05）。与稳定组比较，排异组受者外周血CD3＋、CD4＋T淋巴细胞百分比及CD4／CD8均明显升高（P均＜0．05）。与稳定组比较，感染组受者外周血CD3＋、CD4＋T淋巴细胞百分比及CD4／CD8明显降低（P均＜0．05）。感染组CD3＋、CD4＋与ATP呈正相关，CD4＋／CD8＋与ATP无相关性；排异组CD4＋／CD8＋与ATP呈正相关，CD3＋和CD4＋与ATP无相关性。感染组感染治愈后ATP明显回升，排异组在急性排异反应治愈后ATP明显下降（P＜0．05）。结论肝移植术后联合检测CD4＋T细胞ATP和T淋巴细胞亚群，对判断肝移植受者的免疫状态、移植后感染和诱导免疫耐受均有重要作用。%Objective To investigate the monitoring effects of combined detections of ATP and T lymphocyte subsets in CD4+T lymphocytes of peripheral blood on immune function in patients after liver transplantation .Methods Eighty ca-ses of liver transplant recipients , including 30 cases of patients with stable condition after operation (stable group), 30 ca-ses of patients with infection ( infection group ) and 20 patients with acute rejection ( rejection group ) , and 30 healthy con-trols ( control group ) were selected .The concentrations of ATP in CD 4+T lymphocytes were detected by Cylex +ImmuKnow method, and the percentages of T-lymphocyte subsets were determined by flow cytometry .The changes of ATP and T lym-phocyte subsets were compared in each group and their correlations were analyzed .Results The ATP level of the infection group was significantly lower than that of the stable and control groups , and the ATP level of the rejection group was signifi-cantly higher than that of the stable and control groups (all P<0.05).Compared with the stable group, the CD3+and CD4+T lymphocyte percentage , CD4/CD8 in the peripheral blood of the rejection group were significantly higher ( all P<0.05);and the CD3+and CD4+T lymphocyte percentage , CD4/CD8 in the peripheral blood of the infection group were sig-nificantly lower (all P<0.05).In the infection group, CD3+and CD4+was positively correlated with ATP, but CD4+/CD8+had no correlation with ATP .In the rejection group , CD4+/CD8+was positively correlated with ATP , but CD3+and CD4+were not correlated with ATP .The ATP significantly increased after the cure of infection in the infection group , and the ATP significantly decreased after the cure of rejection in the injection group (P<0.05).Conclusion The combined de-tections of ATP and T lymphocyte subsets in CD 4+T lymphocytes of peripheral blood in patients after liver transplantation have important significance to the judgment of the recipients immune status , infection and induced immune tolerance .