同种异体手移植术后细胞因子的动态观察

Dynamic observation of serum cytokines in patients receving hand transplantation

目的 探讨同种异体手移植患者术后血清细胞因子水平的变化和意义。 方法 采用酶联免疫方法动态检测 2例同种异体手移植患者血清中血清白细胞介素 2 (IL 2 ) ,白细胞介素 10 (IL 10 ) ,γ 干扰素 (IFN γ) ,肿瘤坏死因子 (TNF α)水平。 结果 IL 2、IFN γ、TNF α血清水平术后 1周内降低 ,1周后恢复至术前水平 ,随后逐渐降低并维持在低水平。IL 10在术后 1周内明显升高 ,随后逐渐降低并维持在低水平 ,5个月后又中度升高。 结论 同种手移植术后细胞因子谱系由Th1向Th2的转换提示术后免疫抑制方案十分有效。同种异体手移植后患者无明显的排斥反应与临床观察相符 ,提示细胞因子的监测有助于同种异体手移植预后的判断和排斥反应的诊断。

Objective To investigate the chan ges of serum levels of cytokines in patients receiving hand transplantation. Methods The serum levels of IL-2, IL-10, TNF- α, and IFN-γ in 2 hand transplant recipients were measured by enzyme-linked immunosobent assays (ELISA). Results The seru m levels of IL-2, TNF-α, and IFN-γ in the 2 patients decreased significantl y during the first posttransplant week, then increased gradually to the pretrans plant levels, and finally decreased and maintained the low level. The serum lev el of IL-10 in the patients increased significantly during the first posttransp lant week, and decreased gradually to the low level. At 5 posttransplant months, the serum level of IL-10 increased moderately again. Conclus ion The predominance of Th2 over Th1 confirms the efficiency of immunosuppressive drug regimens, which contribute to the survival of hand trans plant. Hand transplantation does not elicit significant immune rejection. The dy namic determination of cytokines helps judge the prognosis and diagnosis of reje ction in hand transplantation.