CAJ | 학술논문

目的采用改良的信号连接T细胞受体重排删除环(sjTREC)定量方法检测异基因造血干细胞移植患者胸腺输出功能并分析其影响因素.方法采用实时荧光定量聚合酶链反应(PCR)技术检测26例异基因造血干细胞移植患者各时期(移植前及移植后14d、28 d、3个月、6个月、9个月、1年、1.5年、2年、2.5年、2.5年以上)外周血sjTREC水平,分析胸腺输出功能及影响因素.以24名健康体检者sjTREC作为对照.结果健康体检者外周血Log(sjTREC copies/ml)为3.74±0.26,与年龄呈负相关(r=-0.65,P＜0.01),与性别无明显相关性；患者移植前外周血Log(sjTREC copies/ml)为3.09±0.52,移植后14d、28 d、6个月、1年外周血Log(sjTREC copies/ml)分别为1.18±0.22、2.16±0.31、1.31±0.20、1.83±0.31,1年后恢复到移植前水平,1.5年时为2.15±0.35,与健康对照组比较差异无统计学意义(P＞0.05)；移植后sjTREC的恢复与年龄无明显相关性；合并有急性移植物抗宿主病(aGVHD)患者,移植1年内外周血sjTREC含量较低,1.5年后与无aGVHD者无明显区别.结论改良的sjTREC定量方法,适用于研究异基因造血干细胞移植后胸腺输出功能；异基因造血干细胞移植后胸腺功能恢复缓慢,aGVHD影响移植后早期胸腺功能的恢复.
목적 채용개량적신호련접T세포수체중배산제배(sjTREC)정량방법검측이기인조혈간세포이식환자흉선수출공능병분석기영향인소.방법 채용실시형광정량취합매련반응(PCR)기술검측26례이기인조혈간세포이식환자각시기(이식전급이식후14d、28 d、3개월、6개월、9개월、1년、1.5년、2년、2.5년、2.5년이상)외주혈sjTREC수평,분석흉선수출공능급영향인소.이24명건강체검자sjTREC작위대조.결과 건강체검자외주혈Log(sjTREC copies/ml)위3.74±0.26,여년령정부상관(r=-0.65,P＜0.01),여성별무명현상관성；환자이식전외주혈Log(sjTREC copies/ml)위3.09±0.52,이식후14d、28 d、6개월、1년외주혈Log(sjTREC copies/ml)분별위1.18±0.22、2.16±0.31、1.31±0.20、1.83±0.31,1년후회복도이식전수평,1.5년시위2.15±0.35,여건강대조조비교차이무통계학의의(P＞0.05)；이식후sjTREC적회복여년령무명현상관성；합병유급성이식물항숙주병(aGVHD)환자,이식1년내외주혈sjTREC함량교저,1.5년후여무aGVHD자무명현구별.결론 개량적sjTREC정량방법,괄용우연구이기인조혈간세포이식후흉선수출공능；이기인조혈간세포이식후흉선공능회복완만,aGVHD영향이식후조기흉선공능적회복.
Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation (all-HSCT),and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients.Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation,14 d,28 d,3 m,6 m,9 m,1 y,1.5 y,2 y,2.5 y,and above 2.5 y after HSCT,and analyse thymic output function and related factors after HSCT.sjTREC levels in 24 normal individuals were also determined to use as the normal range.Results The mean of Log (sjTREC copies/ml) in normal individuals was 3.74±0.26.Negative correlation existed between thte Log sjTREC and the age (r =-0.65,P ＜ 0.01).There was no clear association between the TREC and the gender.Log sjTREC in pre-transplantation patients was 3.09±0.52,and the levels of sjTREC in 14 d,28 d,6 m,1 y after HSCT were 1.18±0.22,2.16±0.31,1.31±0.2,1.83±0.31,respectively.There was no significant difference between normal individuals and patients 1.5 years after HSCT.The post-transplantation level of sjTREC was not related to the age,but was negatively correlated to the acute graft versus host disease (aGVHD) 1 year after HSCT.There was no difference between patients with or without aGVHD 1.5 years post-HSCT.Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT.The recovery of thymic output function after allo-HSCT is slow,in which aGVHD may have a negative effect.