中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2014年
7期
1559-1562
,共4页
杨卫平%朱纯超%景晓乾%汪炳瑞%沈柏用%彭承宏%邱伟华
楊衛平%硃純超%景曉乾%汪炳瑞%瀋柏用%彭承宏%邱偉華
양위평%주순초%경효건%왕병서%침백용%팽승굉%구위화
人工肝%血浆置换%细胞免疫%白细胞介素-17
人工肝%血漿置換%細胞免疫%白細胞介素-17
인공간%혈장치환%세포면역%백세포개소-17
Artificial liver%Plasma exchange%Cellular immunity%Interleukin-17
目的 探讨人工肝血浆置换(PE)治疗前后肝功能衰竭患者外周血T淋巴细胞亚群及白细胞介素(IL)-17等移植相关免疫指标变化的临床意义.方法 将28例肝移植术后肝功能衰竭患者和20例肝功能衰竭患者分别纳入研究组和对照组,采集PE术前、术后即刻、术后1d和术后2d的外周抗凝血和血清,应用流式细胞技术分别检测不同时间段T淋巴细胞亚群百分计数,应用酶联免疫吸附试验(ELISA)法检测血清IL-17浓度变化.结果 肝移植组患者治疗前的CD3+T细胞[(58.12±4.98)%]、CD4+T细胞[(28.85 ±4.18)%]和CD4+/CD8+比值(1.18)显著低于对照组,而CD4+ CD25+ Foxp3+T细胞[(10.58±5.01)%]则高于对照组.PE治疗后移植组患者的CD3+T细胞迅速增高到(66.07±4.75)%,CD4+T细胞增高到(37.16 ±3.89)%,CD4 +/CD8+比值由1.18升高到1.35.CD4+ CD25+ Foxp3+T细胞百分计数在后当天即明显降低至(6.89±4.98)%,而后逐渐上升至术前水平.PE治疗对对照组患者T细胞亚群有类似作用,但作用强度低于对移植后患者.移植组患者PE治疗前的IL-17浓度[(85.175±50.151) ng/L]显著低于对照组[(198.042±80.985) ng/L],PE术后2组患者IL-17均即刻显著升高,而且移植组患者IL-17升高幅度比对照组更为明显.结论 肝移植后肝功能衰竭患者处于免疫抑制状态,PE治疗后细胞免疫功能显著增强,在稳定内环境和同时可能导致排异反应的加剧.
目的 探討人工肝血漿置換(PE)治療前後肝功能衰竭患者外週血T淋巴細胞亞群及白細胞介素(IL)-17等移植相關免疫指標變化的臨床意義.方法 將28例肝移植術後肝功能衰竭患者和20例肝功能衰竭患者分彆納入研究組和對照組,採集PE術前、術後即刻、術後1d和術後2d的外週抗凝血和血清,應用流式細胞技術分彆檢測不同時間段T淋巴細胞亞群百分計數,應用酶聯免疫吸附試驗(ELISA)法檢測血清IL-17濃度變化.結果 肝移植組患者治療前的CD3+T細胞[(58.12±4.98)%]、CD4+T細胞[(28.85 ±4.18)%]和CD4+/CD8+比值(1.18)顯著低于對照組,而CD4+ CD25+ Foxp3+T細胞[(10.58±5.01)%]則高于對照組.PE治療後移植組患者的CD3+T細胞迅速增高到(66.07±4.75)%,CD4+T細胞增高到(37.16 ±3.89)%,CD4 +/CD8+比值由1.18升高到1.35.CD4+ CD25+ Foxp3+T細胞百分計數在後噹天即明顯降低至(6.89±4.98)%,而後逐漸上升至術前水平.PE治療對對照組患者T細胞亞群有類似作用,但作用彊度低于對移植後患者.移植組患者PE治療前的IL-17濃度[(85.175±50.151) ng/L]顯著低于對照組[(198.042±80.985) ng/L],PE術後2組患者IL-17均即刻顯著升高,而且移植組患者IL-17升高幅度比對照組更為明顯.結論 肝移植後肝功能衰竭患者處于免疫抑製狀態,PE治療後細胞免疫功能顯著增彊,在穩定內環境和同時可能導緻排異反應的加劇.
목적 탐토인공간혈장치환(PE)치료전후간공능쇠갈환자외주혈T림파세포아군급백세포개소(IL)-17등이식상관면역지표변화적림상의의.방법 장28례간이식술후간공능쇠갈환자화20례간공능쇠갈환자분별납입연구조화대조조,채집PE술전、술후즉각、술후1d화술후2d적외주항응혈화혈청,응용류식세포기술분별검측불동시간단T림파세포아군백분계수,응용매련면역흡부시험(ELISA)법검측혈청IL-17농도변화.결과 간이식조환자치료전적CD3+T세포[(58.12±4.98)%]、CD4+T세포[(28.85 ±4.18)%]화CD4+/CD8+비치(1.18)현저저우대조조,이CD4+ CD25+ Foxp3+T세포[(10.58±5.01)%]칙고우대조조.PE치료후이식조환자적CD3+T세포신속증고도(66.07±4.75)%,CD4+T세포증고도(37.16 ±3.89)%,CD4 +/CD8+비치유1.18승고도1.35.CD4+ CD25+ Foxp3+T세포백분계수재후당천즉명현강저지(6.89±4.98)%,이후축점상승지술전수평.PE치료대대조조환자T세포아군유유사작용,단작용강도저우대이식후환자.이식조환자PE치료전적IL-17농도[(85.175±50.151) ng/L]현저저우대조조[(198.042±80.985) ng/L],PE술후2조환자IL-17균즉각현저승고,이차이식조환자IL-17승고폭도비대조조경위명현.결론 간이식후간공능쇠갈환자처우면역억제상태,PE치료후세포면역공능현저증강,재은정내배경화동시가능도치배이반응적가극.
Objective To evaluate the influence of plasma exchange (PE) on the transplantationrelated immune function of patients with liver failure.Methods Twenty-eight patients post-transplantation and 20 patients with liver failure were included in the study prospectively.The peripheral blood samples were collected at the set time points.The percentages of T lymphocytes were detected by flow cytometer with different fluorescence labels including CD3-fluoresceine isothiocyanate (FITC),CD4-peridinin chlorophyll protein (PerCP),CD8-phycoerylhrin (PE),CD25-FITC and Foxp3-PE.The changes of interleukin (IL)-17 concentration were identified by enzyme linked immunosorbent assay (ELISA).Results The percent countings of CD3+ T cells [(58.12 ±4.98)%],CD4+ T cells [(28.85 ±4.18)%] and CD4+/CD8+ ratio (1.18) in patients post-transplantation were significantly lower than those in regular patients.After PE treatment,in patients post-transplantation,the percent counting of CD3+ T cells,CD4+ T cells and CD4 +/CD8 + ratio were increased to (66.07 ± 4.75) %,(37.16 ± 3.89) % and 1.35,respectively,after the procedure and then reduced back gradually.The ratio of CD4 + CD25 + Foxp3 + T cells (Treg) was decreased to (6.89 ± 4.98) % immediately after treatment.The similar changes were observed as well in control group,however,the effects were less apparent than those in transplantation group.The concentration of IL-17 was lower in transplantation group [(85.175 ±50.151) ng/L] and increased significantly in both groups following PE at very early stage.The change was more remarkable in transplantation group.Conclusion PE treatment is meaningful in accommodation of the cellular immune function of patients post-transplantation and the transplant rejection could be aggravated.