重症巨细胞病毒感染和急性排斥肾移植受者T淋巴细胞亚群的动态变化

T-lymphocyte subsets monitoring in kidney transplant recipients undergoing severe cytomegalovirus infection or acute rejection episodes

目的 :探讨肾移植受者外周血 T淋巴细胞亚群与发生重症巨细胞病毒 (CMV)感染和急性排斥反应(AR)之间的关系。方法 :采用 COUL TER公司生产的鼠抗人 T淋巴细胞亚群单克隆抗体 OKT系列及 EL ITE型流式细胞仪对 2 3例重症 CMV感染者、8例 AR患者和 2 0例正常肾移植者的外周血 T淋巴细胞亚群进行动态测定。结果 :术后无 AR者与 AR者、排斥反应缓解者与未缓解者 ,其 CD4/ CD8比值变化差异有显著性意义 (P <0 .0 5 ) ;而发生重症 CMV感染者的 CD4/ CD8比值变化与 AR者完全相反。结论 :外周血 T淋巴细胞亚群的动态变化对肾移植受者 AR和重症 CMV感染的诊断、鉴别诊断以及指导临床合理用药有一定意义。

Purpose:To investigate the relationship of peripheral blood T-lymphocyte subsets with the acute rejection or severe CMV infection in transplanted patients.Methods:T-lymphocytes subsets of peripheral blood were consecutively detected by using mice-verse-human T-lymphocytes subsets monoclonal antibody-OKT serials and flow cytometer.Results:The difference of CD 4/CD 8 ratios between the no acute rejection group and the acute rejection group, or between the acute rejection remission group and the resistant acute rejection group was significant (P< 0.05 ); In patients with intensive CMV infection, the CD 4/CD 8 ratios were converse to the acute rejection group.Conclusions:These results indicated that monitoring of peripheral blood T-lymphocyte subsets was of much benefit to early diagnosis and differential diagnosis of acute rejection of intensive CMV infection and reasonable treatment.