器官移植
器官移植
기관이식
Organ Transplantation
2015年
6期
429-433
,共5页
张磊%陈正%张异蕊%郭予和%马俊杰%方佳丽%李光辉%徐璐%潘光辉
張磊%陳正%張異蕊%郭予和%馬俊傑%方佳麗%李光輝%徐璐%潘光輝
장뢰%진정%장이예%곽여화%마준걸%방가려%리광휘%서로%반광휘
肾移植%免疫细胞功能检测%三磷腺苷%T 细胞亚群%重症肺炎%急性排斥反应
腎移植%免疫細胞功能檢測%三燐腺苷%T 細胞亞群%重癥肺炎%急性排斥反應
신이식%면역세포공능검측%삼린선감%T 세포아군%중증폐염%급성배척반응
Renal transplantation%Immune cell function assay%Adenosine triphosphate%T cell subset%Severe pneumonia%Acute rejection
目的：探讨 ImmuKnow 检测免疫细胞功能在监测肾移植术后患者免疫功能变化的应用价值。方法2013年1月至2014年12月在广州医科大学附属第二医院器官移植科实施肾移植手术的106例尿毒症患者，分别于术前、术后12个月内发生感染或急性排斥反应时抽取血液标本。采用ImmuKnow 测定 CD4＋ T 细胞内的三磷腺苷（ATP）含量。观察与比较不同临床状态肾移植患者的 ATP含量，包括术前组、稳定组、急性排斥反应组和感染组（含重症肺炎）。检测外周血 T 细胞亚群CD4＋T 细胞、CD8＋T 细胞及自然杀伤（NK）细胞比例。采用 Pearson 相关分析法了解 ATP 值与他克莫司（FK506）和环孢素（CsA）血药谷浓度的关系。结果感染组患者 ATP 含量低于术后稳定组患者（P ＜0.001），其中发生重症肺炎患者 ATP 含量低于发生其他感染的患者（P ＜0.05）。感染组患者的 CD4＋T 细胞百分比低于稳定组患者（P ＜0.05）。ATP 含量与移植患者术后 FK506和 CsA 血药谷浓度无相关性。结论ImmuKnow 检测可用于监测肾移植患者术后免疫功能状态。CD4＋T 细胞内 ATP 含量检测对术后感染，特别是对重症肺炎有提示和预警作用。
目的：探討 ImmuKnow 檢測免疫細胞功能在鑑測腎移植術後患者免疫功能變化的應用價值。方法2013年1月至2014年12月在廣州醫科大學附屬第二醫院器官移植科實施腎移植手術的106例尿毒癥患者，分彆于術前、術後12箇月內髮生感染或急性排斥反應時抽取血液標本。採用ImmuKnow 測定 CD4＋ T 細胞內的三燐腺苷（ATP）含量。觀察與比較不同臨床狀態腎移植患者的 ATP含量，包括術前組、穩定組、急性排斥反應組和感染組（含重癥肺炎）。檢測外週血 T 細胞亞群CD4＋T 細胞、CD8＋T 細胞及自然殺傷（NK）細胞比例。採用 Pearson 相關分析法瞭解 ATP 值與他剋莫司（FK506）和環孢素（CsA）血藥穀濃度的關繫。結果感染組患者 ATP 含量低于術後穩定組患者（P ＜0.001），其中髮生重癥肺炎患者 ATP 含量低于髮生其他感染的患者（P ＜0.05）。感染組患者的 CD4＋T 細胞百分比低于穩定組患者（P ＜0.05）。ATP 含量與移植患者術後 FK506和 CsA 血藥穀濃度無相關性。結論ImmuKnow 檢測可用于鑑測腎移植患者術後免疫功能狀態。CD4＋T 細胞內 ATP 含量檢測對術後感染，特彆是對重癥肺炎有提示和預警作用。
목적：탐토 ImmuKnow 검측면역세포공능재감측신이식술후환자면역공능변화적응용개치。방법2013년1월지2014년12월재엄주의과대학부속제이의원기관이식과실시신이식수술적106례뇨독증환자，분별우술전、술후12개월내발생감염혹급성배척반응시추취혈액표본。채용ImmuKnow 측정 CD4＋ T 세포내적삼린선감（ATP）함량。관찰여비교불동림상상태신이식환자적 ATP함량，포괄술전조、은정조、급성배척반응조화감염조（함중증폐염）。검측외주혈 T 세포아군CD4＋T 세포、CD8＋T 세포급자연살상（NK）세포비례。채용 Pearson 상관분석법료해 ATP 치여타극막사（FK506）화배포소（CsA）혈약곡농도적관계。결과감염조환자 ATP 함량저우술후은정조환자（P ＜0.001），기중발생중증폐염환자 ATP 함량저우발생기타감염적환자（P ＜0.05）。감염조환자적 CD4＋T 세포백분비저우은정조환자（P ＜0.05）。ATP 함량여이식환자술후 FK506화 CsA 혈약곡농도무상관성。결론ImmuKnow 검측가용우감측신이식환자술후면역공능상태。CD4＋T 세포내 ATP 함량검측대술후감염，특별시대중증폐염유제시화예경작용。
Objective To investigate the application value of ImmuKnow immune cell function assay in monitoring of immune function changes after renal transplantation.Methods One hundred and six patients with uraemia undergoing renal transplantation in the Department of Organ Transplantation of the Second Affiliated Hospital of Guangzhou Medical University from January 201 3 to December 201 4 were included.Blood specimens were collected before transplantation and at the occurrence of infection or acute rejection during 1 2 months after transplantation.ImmoKnow was used to determine the adenosine triphosphate (ATP)content in CD4 +T cells.The ATP content of patients with renal transplantation at different clinical conditions were observed and compared,including periopreative group,stable group,acute rejection group and infecticn group (including severe pneumonia).The ratio of T cell subsets (CD4 +T cells,CD8 +T cells)and natural killer (NK)cells in peripheral blood were detected.Pearson correlation analysis was used to detect the association between ATP and the blood trough concentration of tacrolimus (FK506)and ciclosporin (CsA).Results The ATP content of the patients in the infection group was lower than that of the patients in the stable group (P <0.001 ).The ATP content of patients with severe pneumonia was lower than that of patients with other infections (P <0.05).The percentage of CD4 +T cells of the patients in the infection group was lower than that of the patients in the postoperative stable group (P <0.05 ). The ATP content was not associated with the postoperative blood trough concentration of FK506 and CsA.Conclusions ImmuKnow assay may be used to monitor the postoperative immune function of patients after renal transplantation.The detection of ATP content in CD4 + T cells has hinting and pre-warning function for postoperative infection,especially for severe pneumonia.
