中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2010年
10期
758-760
,共3页
董家勇%李瑞东%殷浩%郭闻渊%林峰%滕飞%邹游%马钧%丁国善%傅志仁%王正昕
董傢勇%李瑞東%慇浩%郭聞淵%林峰%滕飛%鄒遊%馬鈞%丁國善%傅誌仁%王正昕
동가용%리서동%은호%곽문연%림봉%등비%추유%마균%정국선%부지인%왕정흔
肝移植%排斥反应%T淋巴细胞%三磷酸腺苷
肝移植%排斥反應%T淋巴細胞%三燐痠腺苷
간이식%배척반응%T림파세포%삼린산선감
Liver transplantation%Rejection%T lymphocyte%Adenosine triphosphate
目的 探讨CD4+T细胞ATP含量与肝移植术后围手术期急性排斥反应(acute rejection,AR)的关系.方法 以2009年2月至2009年10月在本院行肝移植术的77例病人为研究对象.肝移植病人术前以及术后1、2、4周各采集1份全血标本,发生AR当日和激素冲击治疗后1周各采集1份全血标本.每次均送检1～2份健康志愿者全血标本作为对照.用ImmuKnowTM免疫细胞功能测定试剂盒检测样本中CD4+T细胞ATP值.结果 AR组病人ATP值在术后第1周达到高峰,显著高于同期非排斥组.术后第1周的高ATP值对诊断肝移植术后围手术期AR具有较好的敏感度和特异度.AR组病人排斥当日的ATP值与排斥活动指数(RAI)呈显著正相关,经激素冲击治疗1周后,AR均达到逆转,ATP值明显降低.结论 肝移植术后围手术期,CD4+T细胞ATP值动态变化与移植肝急性排斥反应密切相关,有望成为诊断和预防围手术期AR发生以及抗排斥治疗效果的无创监测指标.
目的 探討CD4+T細胞ATP含量與肝移植術後圍手術期急性排斥反應(acute rejection,AR)的關繫.方法 以2009年2月至2009年10月在本院行肝移植術的77例病人為研究對象.肝移植病人術前以及術後1、2、4週各採集1份全血標本,髮生AR噹日和激素遲擊治療後1週各採集1份全血標本.每次均送檢1～2份健康誌願者全血標本作為對照.用ImmuKnowTM免疫細胞功能測定試劑盒檢測樣本中CD4+T細胞ATP值.結果 AR組病人ATP值在術後第1週達到高峰,顯著高于同期非排斥組.術後第1週的高ATP值對診斷肝移植術後圍手術期AR具有較好的敏感度和特異度.AR組病人排斥噹日的ATP值與排斥活動指數(RAI)呈顯著正相關,經激素遲擊治療1週後,AR均達到逆轉,ATP值明顯降低.結論 肝移植術後圍手術期,CD4+T細胞ATP值動態變化與移植肝急性排斥反應密切相關,有望成為診斷和預防圍手術期AR髮生以及抗排斥治療效果的無創鑑測指標.
목적 탐토CD4+T세포ATP함량여간이식술후위수술기급성배척반응(acute rejection,AR)적관계.방법 이2009년2월지2009년10월재본원행간이식술적77례병인위연구대상.간이식병인술전이급술후1、2、4주각채집1빈전혈표본,발생AR당일화격소충격치료후1주각채집1빈전혈표본.매차균송검1～2빈건강지원자전혈표본작위대조.용ImmuKnowTM면역세포공능측정시제합검측양본중CD4+T세포ATP치.결과 AR조병인ATP치재술후제1주체도고봉,현저고우동기비배척조.술후제1주적고ATP치대진단간이식술후위수술기AR구유교호적민감도화특이도.AR조병인배척당일적ATP치여배척활동지수(RAI)정현저정상관,경격소충격치료1주후,AR균체도역전,ATP치명현강저.결론 간이식술후위수술기,CD4+T세포ATP치동태변화여이식간급성배척반응밀절상관,유망성위진단화예방위수술기AR발생이급항배척치료효과적무창감측지표.
Objective To explore the relationship between ATP content in CD4+ T lymphocytes and acute rejection after liver transplantation(LT). Methods This study contained 77 patients who received LT from February to October 2009, They were divided into AR (acute rejection) and NAR (non-acute rejection) groups while 56 healthy people were enrolled to serve as the control group.Blood specimens were collected preoperatively and at 1, 2 and 4 weeks postoperatively. For the AR group, specimens were also collected on the day when AR occurred and 1 week after steroid bump together with that of the healthy people. ImmuKnowTM test kits for immune cell function were used to assay the ATP value. Results ATP values within CD4+T lymphocytes were elevated significantly in each group compared with those preoperatively. Peak level was reached in the AR group and was significantly higher than that of the contemporary NAR group (P＜0.05). ROC curve analysis showed that the obvious elevation of the ATP value within CD4+ T lymphocytes 1 week postoperatively had better sensitivity and specificity in diagnosing AR. The ATP sensitivity rate for early AR was 84.6 %and specificity rate 81 %. The ATP value within CD4+ T lymphocytes on the day of AR occurrence had a positive relationship with the rejection acting index(RAI), while relative index (r) was 0. 876(P＜0.05). After the steroid dump treatment, AR in all the patients was reversed and the ATP value declined significantly as compared with the control group and the day when AR occurred(P＜0. 05).Conclusion During the postoperative period, the dynamic change of ATP value within CD4 + T lymphocyte had a close relationship with acute rejection after liver transplantation. Thus, it might be used as a feasible and noninvasive monitoring index for diagnosing AR and the effectiveness of the anti-rejection treatment.
