CAJ | 학술논문

目的探讨适用于评价肾移植受者免疫状态的新方法.防止移植后的排斥反应和感染,提高人/肾生存质量和存活率.方法应用ImmuKnow~(TM)-Cylex检测技术测定肾移植受者细胞免疫能量(三磷酸腺苷,ATP).收集62例肾移植受者术前(术前组)、术后稳定期(术后稳定组)、发生感染(术后感染组)和排斥反应(排斥反应组)等不同时期的肝素钠抗凝样本共150份.通过测量CD4+T淋巴细胞受刺激后释放的ATP浓度来判定细胞免疫力.并用秩和检验和两两比较统计方法,对结果进行分析和比较.结果各组肾移植受者CD4+T淋巴细胞ATP浓度分别为:术前组(281.33±146.46)/μg/L、术后稳定组(310.19±147.12)/μg/L、术后感染组(142.41±118.26)μg/L、排斥反应组(332.77±154.44)μg/L;术后感染组ATP浓度显著低于其他各组.差异均有统计学意义(P<0.05).结论 LmmuKnow~(TM)-Cylex细胞免疫能量测定具有灵敏度高、特异性强、简便易操作等优点,适合于肾移植受者免疫状态的临床监测,特别是对术后感染有很好的预警作用,对指导感染后免疫抑制剂的个体化用药具有一定的参考价值.
목적 탐토괄용우평개신이식수자면역상태적신방법.방지이식후적배척반응화감염,제고인/신생존질량화존활솔.방법 응용ImmuKnow~(TM)-Cylex검측기술측정신이식수자세포면역능량(삼린산선감,ATP).수집62례신이식수자술전(술전조)、술후은정기(술후은정조)、발생감염(술후감염조)화배척반응(배척반응조)등불동시기적간소납항응양본공150빈.통과측량CD4+T림파세포수자격후석방적ATP농도래판정세포면역력.병용질화검험화량량비교통계방법,대결과진행분석화비교.결과 각조신이식수자CD4+T림파세포ATP농도분별위:술전조(281.33±146.46)/μg/L、술후은정조(310.19±147.12)/μg/L、술후감염조(142.41±118.26)μg/L、배척반응조(332.77±154.44)μg/L;술후감염조ATP농도현저저우기타각조.차이균유통계학의의(P<0.05).결론 LmmuKnow~(TM)-Cylex세포면역능량측정구유령민도고、특이성강、간편역조작등우점,괄합우신이식수자면역상태적림상감측,특별시대술후감염유흔호적예경작용,대지도감염후면역억제제적개체화용약구유일정적삼고개치.
Objective To investigate a new applicable method for determining immune cell function (ATP value) in kidney transplant recipients measured by the ImmuKnow assay in order to minimize the risk of infection or rejection and improve graft function.Methods 150 heparinized blood samples were taken from 62 kidney recipients before and after transplantation.By using ImmuKnow assay, cell-mediated immunity (CMI) was assessed by measuring the concentration of ATP from CD4+ cells following stimulation.Rank sum test was used for analysis of data.Results The mean ATP value in the recipients with infection after kidney transplantation was (142.41±118.26) μg/L, significantly lower than that in pretransplant recipients [(281.33±146.46) μg/L], stable recipients [(310.19±147.12) μg/L] and the recipients with rejection [(332.77±154.44) μg/L], P<0.05.Conclusion With its good qualities of high sensitivity and specificity, ImrnuKnow assay is a valuable tool in monitoring immune status in posttransplant recipients and especially in predicting infectious complications.It can guide therapy decisions to better individualize and adjust immunosuppressant regimens in the treatment of infection.