活化T淋巴细胞亚群检测在肾移植术后急性排斥反应和CMV感染鉴别中的应用

Clinical application of monitoring activated T-lymphocytes in differential diagnosis of acute rejection and CMV infection after renal transplantation

目的探讨活化T淋巴细胞亚群在肾移植急性排斥反应(AR)和巨细胞病毒(CMV)感染鉴别诊断中的价值和意义。方法采用回顾性调查法,分析移植肾功能正常组(稳定组)、AR组、CMV感染组、健康对照组外周血CD25+HLA-DR-T淋巴细胞和CD25-HLA-DR+T淋巴细胞亚群的含量;外周血活化T淋巴细胞亚群检测采用FSC/SSC设门的三色流式细胞术。结果 AR组患者外周血CD3+CD25-HLA-DR+淋巴细胞亚群和CD3+CD25+HLA-DR-淋巴细胞亚群的百分含量及绝对含量均较对照组明显升高(P<0.01或P<0.05),而CMV感染组仅CD3+CD25-HLA-DR+淋巴细胞亚群的百分含量和绝对含量较对照组升高(P<0.01)。AR组和CMV感染组比较发现,两组患者外周血CD3+CD25-HLA-DR+淋巴细胞亚群之间差异无统计学意义(P>0.05),AR组CD3+CD25+HLA-DR-淋巴细胞亚群的百分含量和绝对含量均较CVM感染组高(P<0.01或P<0.05)。结论外周血CD25+HLA-DR-T淋巴细胞和CD25-HLA-DR+淋巴细胞亚群含量的测定可以用于肾移植患者术后AR和CMV感染的诊断与鉴别。

Objective To analyze the differential diagnostic value and efficacy of activated T-lymphocyte detected by flow cytom etry between acute rejection （AR） and cytomegalovirus （CMV） infection after renal transplantation. Methods All subjects were divided into 4 groups,including group with normal renal, function and without rejection （group A）, group with AR （group B）, group with CMV infection （group C） and group of healthy volunteers （group D）. Peripheral blood collected from all subjects were ana lyzed for CD25^＋ HLA DR T lymphocyte and CD25 HLA DR^＋ T lymphocyte by using FSC/SSC gated three-color flow cytome try. Results Percentage and absolute counts of peripheral blood CD25^＋ HLA-DR T lymphocyte and CD25^＋ HLA DR^＋ T lympho cyte in group B were significantly higher than those in group D（P〈0.01 or P〈0.05） ,and only percentage and absolute counts of CD25 HLA-DR＋ T lymphocyte in group C were higher than those in group D significantly（P〈0.01）. There was no statistical difference of the percentage and absolute counts of CD3^＋ CD25^＋ HLA-DR^＋ T lymphocyte between group B and group C （P〉 0.05） ,but those of CD3^＋CD25^＋ HLA-DR^＋ T lymphocyte in group B were higher than those in group C （P〈0. 01 or P〈0.05）. Conclusion The determination of peripheral blood CD25^＋ HLA DR T lymphocyte and CD25 HLA-DR^＋T lymphocyte by flow cytometry could be used for the diagnosis and differential diagnosis between AR and CMV infection after renal transplantation.