异体手移植术后ATG治疗过程中T淋巴细胞亚群的监测(附3例报告)

Monitoring of T lymphocyte subset during ATG induction therapy in hand allograft with report of 3 cases

目的探讨异体手移植中使用抗胸腺细胞球蛋白(ATG)治疗时T淋巴细胞亚群监测对于指导药物用量、减少并发症和减少治疗费用的意义。方法通过流式细胞仪测定我院完成的3例异体手移植患者外周血中T淋巴细胞亚群(CD3+、CD4+、CD8+、CD28、CD4/CD8)的变化。结果使用ATG治疗期间CD3、CD4、CD8均明显下降,3例患者无明显差异;ATG治疗后外周血中淋巴细胞长期持续改变。结论通过T淋巴细胞亚群的监测了解患者应用ATG后免疫状态,有利于调整ATG用量,预防并发症的发生。

Objective To investigate the significance of T lymphocyte subset determination during antithymocyte globulin (ATG) induction therapy in reducing the total drug dose, incidence of complications and cost of treatment in hand allograft. Methods The changes in peripheral blood T lymphocyte subsets (CD3+, CD4+, CD8+, and CD28) were determined by flow cytometry in 3 cases of hand allograft who received ATG treatment. Results Flow cytometry showed that the percentages of CD3+, CD4+, and CD8+ T lymphocytes, along with the ratio of CD4/CD8, decreased significantly during ATG induction therapy, and the results were consistent in the 3 cases. Long-term continuous changes of peripheral blood lymphocytes were observed after antithymocyte globulin induction therapy. Conclusion The understanding of the immunological state of the patient with hand allograft after ATG induction therapy by monitoring T lymphocyte subsets may allow adjustment of the total dose of the drugs administered and help prevent the occurrence of complications.