HBV感染者肝移植后淋巴细胞亚群变化分析

Analysis for post-transplant changes of peripheral lymphocyte subsets in liver transplant receptors with HBV infection

目的:探讨HBV感染患者肝移植后短期淋巴细胞亚群和细胞因子的变化规律,为肝移植后免疫状态的监测提供依据。方法:用流式细胞术(FCM)和酶联免疫吸附试验(ELISA)检测20例HBV感染相关的终末期肝病和肝癌患者肝移植前和移植后12 h、3 d、10 d、30 d、60 d的外周血淋巴细胞亚群和细胞因子水平,与22例健康人比较。结果:HBV感染患者肝移植前淋巴细胞各亚群绝对值显著低于健康对照,移植后12 h淋巴细胞各亚群绝对值大大降低,3 d后回升,移植后10 d起CD3、CD4、CD8及NK细胞百分比和绝对值达到稳定,60 d时其绝对值比移植前大大升高,但仍显著低于健康对照;移植后12 h时IFN-γ和IL-10水平升高数倍,3 d后显著下降,60 d时IL-10水平仍高于健康对照。结论:肝移植后10 d患者淋巴细胞亚群绝对数量升高至稳定水平,但仍低于正常;肝移植后免疫倾向于Th2极化。

AIM：To investigate the characters and changes of peripheral lymphocyte subsets and cytokines in liver transplant receptors with HBV infection in short phases after liver transplantation,and to provide evidences for monitoring post-transplant immune condition of liver transplant receptors.METHODS：Peripheral lymphocyte subsets and cytokine levels in pre-and post-transplant 12 h,3 d,10 d,30 d,60 d of 20 cases of patients with HBV-associated severe hepatic diseases were investigated and analyzed,and were compared respectively with those of 22 cases of healthy adults as control（HC） with flow cytometry（FCM） and ELISA.RESULTS：The patients＇ accounts of peripheral lymphocyte subsets before liver transplantation were lower than those of HC significantly,but the accounts decreased significantly after transplantation 12 h.Three days later,the accounts of lymphocyte subsets increased significantly.The percentages of CD3,CD4,CD8 and NK cells got to stable stage from post-transplantation 10 d,and the absolute accounts of post-transplantation 60 d were higher than those of pre-transplantation,but were still lower than those of HC;The IFN-γ and IL-10 levels of post-transplantation 12 h increased several times and decreased after 3 days.The IL-10 levels in post-transplantation 60 d were still higher than those of HC.CONCLUSION：The absolute accounts of peripheral lymphocyte subsets increased to stable levels from post-transplantation 10 d,but were still lower than those of HC;Post-transplant immune condition was to Th2 polarization.