肝移植患者围手术期红细胞免疫功能与T、B淋巴细胞亚群的关系

Correlation between red cell nature-immune-adhesion function and T, B lymphocyte immune function in liver transplantation patients during the perioperative period

背景:国内多中心研究结果表明:红细胞天然免疫黏附功能的变化与肝脏损伤程度密切相关,可作为分析病情严重程度、判断病情预后的一项灵敏指标,但在肝移植领域尚未见相关研究与应用。目的:了解肝移植围手术期患者红细胞天然免疫黏附功能和T、B淋巴细胞亚群的变化及二者相关性。方法:采用红细胞C3b受体酵母形成花环实验的方法,检测21例肝移植围手术期患者的红细胞天然免疫黏附功能和T、B淋巴细胞亚群的变化,并进行相关性分析。结果与结论:①肝移植围手术期患者移植前红细胞天然免疫黏附功能低于健康人,移植后第1天降至最低点,移植后2周至移植后1个月可基本恢复至健康人的水平。②肝移植患者移植前T、B淋巴细胞亚群组合中仅表现为CD45低于正常参考范围,其余指标均基本正常;CD4、CD8、CD45于移植后第1天降至最低点,移植后第1周恢复到移植前水平;CD4/CD8、B淋巴细胞在整个围手术期过程中均无明显变化。③红细胞天然免疫黏附功能与T、B淋巴细胞亚群指标之间呈正相关。肝移植围手术期红细胞天然免疫黏附功能的变化较T、B淋巴细胞亚群的变化明显。结果表明红细胞天然免疫黏附功能是反映肝移植围手术期患者肝脏损伤恢复趋势及机体免疫功能变化的更加灵敏的指标。

BACKGROUND： Domestic multi-center study data have shown that erythrocyte nature-immune-adhesion function （RNIAF） had been correlated with the degree of liver damage and can be used as a sensitive indicator for evaluating the degree of diseases and the prognosis of liver transplantation, but RNIAF in the field of liver transplantation has been rarely reported. OBJECTIVE： To investigate the correlation between RNIAF and lymphocyte cell immune function in liver transplantation patients during the perioperative period. METHODS： Twenty-one patients were studied in terms of erythrocyte C3b receptor （CR1） activity and lymphocyte subsets, and a healthy population was used as controls. Yeast rosette formation test was applied to detect the immunocomplex receptor chaplet. The level of RNIAF and lymphocyte subsets was been analyzed and the correlation between them was also studied. RESULTS AND CONCLUSION： The RNIAF level in the control group was 25.89±6.12 /200 erythrocytes. The RNIAF level in the control group was 14.35 ± 5.89 /200 erythrocytes, 10.37 ± 3.48 /200 erythrocytes, 18.60 ± 8.36 /200 erythrocytes, 22.85 ± 8.90 / 200 erythrocytes and 29.14 ± 5.00 /200 erythrocytes, respectively before, 1 day, 1 week, 2 weeks and 1 month after liver transplantation. There was a positive correlation between erythrocyte nature-immune-adhesion function and the level of lymphocyte subsets （CD4, CD8, CD4/CD8, B, CD45）. Significant difference could be observed in RNIAF level during the perioperative period of liver transplantation instead of lymphocyte subsets. RNIAF is a sensitive indicator for evaluating the degree of liver diseases and prognosis of liver transplantation.