淋巴细胞亚群与肾移植术后感染及排斥反应的关系

Relationship between lymphocyte subsets and rena transplantation lpostoperative infection and rejection

目的探讨肾移植术后受者淋巴细胞亚群的动态变化与术后感染及排斥反应的关系。方法术后随访6个月,每两周均需要对三组患者进行一次淋巴细胞亚群计数。根据术后恢复情况将在本院接受同种异体肾移植患者共75例分为术后稳定组、术后感染组、术后排斥组。结果与术后稳定组相比,术后感染组感染前期PBL计数、T细胞计数、NK细胞计数下降(P<0.05),除CD4^(+)/CD8^(+)和NK细胞外,其余淋巴细胞亚群计数均在感染期下降,差异有统计学意义(P<0.05),且治疗后逐渐升高并恢复到与稳定组相当的水平,差异统计学意义(P>0.05);术后排斥组排斥前、排斥中CD4^(+)细胞计数、CD4^(+)/CD8^(+)细胞计数均升高差异有统计学意义(P<0.05),且治疗后逐渐下降恢复到与稳定组相当的水平差异无统计学意义(P>0.05)。结论淋巴细胞亚群可作为肾移植术后患者早期发生排斥或感染的监测指标。

Objective To investigate the relationship between the dynamic changes of lymphocyte subsets in renal transplantation recipients and postoperative infection and rejection.Methods Lymphocyte subsets were counted every two weeks in all three groups for 6 months of follow-up.A total of 75 patients receiving allograft kidney transplantation in our hospital were divided into postoperative stable group,postoperative infection group and postoperative rejection group according to their postoperative recovery.Results Compared with the postoperative stable group,PBL count,T cell count and NK cell count decreased in the postoperative infection group at the early stage of infection(P<0.05),except CD4^(+)/CD8^(+)and NK cells,the count of other lymphocyte subsets decreased at the infection stage(P<0.05).After treatment,they gradually increased and recovered to the same level as the stable group(P>0.05).The CD4^(+)cell count and CD4^(+)/CD8^(+)cell count in the postoperative rejection group were increased before and during rejection(P<0.05),and gradually decreased after treatment to the same level as those in the stable group(P>0.05).Conclusions Lymphocyte subsets can be used as an indicator of early rejection or infection after renal transplantation.