CD4^＋T细胞三磷酸腺苷值及T细胞亚群测定在肝移植术后免疫功能监测中的应用

Application of adenosine-triphosphate value of CD4 ^＋ T cells and T cell subsets analysis in monitoring immune function in post-liver transplantation recipients

目的探讨CD4^＋T细胞三磷酸腺苷（ATP）值及T淋巴细胞亚群测定在肝移植术后免疫功能监测中的应用价值。方法采集48例行肝移植术后患者和30例健康志愿者的外周血样本，采用Irnmuknow免疫细胞功能测定试剂盒，检测CD4^＋T细胞ATP值；流式细胞仪检测外周血T淋巴细胞亚群CD3^＋、CD4^＋、CD8^＋细胞的比例。结果正常人、稳定组、感染组与急性排斥组ATP值分别为（331±103）、（364±125）、（182±104）和（479±116）μg/L，急性排斥组明显高于感染组（P〈0．01）；稳定组与感染组比较，感染组明显降低（P〈0．01）；稳定组与急性排斥组比较差异无统计学意义（P〉0．05）。T淋巴细胞亚群检测结果，稳定组CD4^＋细胞百分比为（33．23±11．34）％，感染组为（25．53±6．89）％，两组比较差异有统计学意义（P〈0．05）。结论CD4^＋T细胞ATP值以及T淋巴细胞亚群CD4^＋细胞百分比能较好地反映肝移植患者术后免疫功能。

Objective To investigate the significance of adenosine-triphosphate （ATP） value of CD4 ~ T cells and T cell subset analysis in monitoring immune function after liver transplantation. Methods Immuknow immune cell function kit was applied to test the ATP value of CD4 ^＋ T cells in peripheral blood from 48 patients undergoing liver transplantation and 30 healthy volunteers. Additionally, the frequency of CD3 ^＋ , CD4^＋and CD8 ^＋ cell subsets was analyzed hy flow cytometry. Results For healthy volunteers, stable recipients, infectious recipients and recipients with acute rejection, the mean ATP levels were （331 ± 103）, （364 ± 125）, （ 182 ± 104） and （479± 116） μg/L, respectively. The ATP levels in acute rejection patients were higher than stable ones （P 〈0. 01 ） and patients with infections （P 〈0. 01 ）. How ever, there was no statistically significant difference between stable recipients and recipients with acute re jection （P 〉 0. 05）. T cell subsets analysis showed that the CD4 ^＋ cell counts were （25.53± 6.89）% in the infectious patients and （ 33.23 ± 11.34 ） % in stable group, there was a significantly different in two groups （ P 〈 0. 05 ）. Conclusion The ATP levels in CD4 ^＋ T cells and T cell subsets analysis can indicate the immune status after liver transplantation to a certain extent.