摘要
目的动态监测活体亲属供肾移植受者术后早期外周血T淋巴亚群,探讨T淋巴亚群与受者免疫状态之间的关系.方法动态监测26例活体亲属供肾移植受者术后早期的T淋巴亚群,肌酐及免疫抑制剂血药浓度,并依据主要免疫抑制剂环孢素(CSA)和他克莫司(FK506)分为两组,对两组临床资料进行统计分析.结果(1)26例受者术后肾功能均恢复良好;(2)各淋巴细胞亚群绝对计数在术后急剧下降,但在术后2周左右逐渐恢复至术前水平,之后逐渐升高,并于术后3月逐渐稳定;(3)26例患者术后早期CD4+T淋巴细胞绝对计数与外周血肌酐显著相关,并建立线性回归方程;(4)受者术后早期CD4+T淋巴细胞绝对计数与血药浓度显著相关,并建立线性回归方程;(5)CD3+,CD8+T淋巴细胞,CD4+/CD8+比值有类似变化但统计学上无明显差异(P>0.05).结论(1)肾功能恢复良好的活体亲属供肾移植受者中,CD4+T淋巴细胞亚群绝对计数能较好的反映肾移植患者免疫状态;(2)活体供肾移植受者术后早期肾功能恢复稳定时,受者术后CD4+T淋巴细胞绝对计数理想范围为:CSA组582～868个/μL;FK506组为555～733个/μL;(3)根据受者术后CD4+T淋巴细胞绝对计数推算理想免疫抑制剂血药浓度,有助于临床合理使用和调整免疫抑制剂剂量.
Objective We monitor the level of the peripheral T-lymphoyte subsets of the recipients in the early stage of living dornor renal transplantation, to find out how these values fluctuate, and then evaluate the relationship between the T-lymphoyte subsets and those recipients＇ immunity conditions. Methods 26 uremic patients were recruited in our study, who were all received live-related kidey transplantation, and their T-lymphoyte subsets and renal function were tested after operation. Acording to undergone CsA or FK506, these patients were devided into two groups, their clinic data were evaluated by statistical program. Results （1） All 26 recipients alleviated significantly; （2） The absolute counts of all lymphocyte subsets decreased abruptly, but got back to the preoperational level 1 week after transplantation, then increased gradually and remained steady 3 months after operation; （3） In early stage after kidney transplantation, 26 recipients＇ absolute counts of CD4^＋T lymphocyte were correlated with the creatine, and a logistic regression equation was set up as well; （4） Athough CD3^＋, CD8^＋ lymphocyte subsets and the ratio of CD4^＋/CD8^＋ had similar fluctuate tendency, the difference was not significant. Conclusions （1） In the living dornor renal transplantation recipients whose renal dysfunction alleviated significantly, the absolute counts of CD4^＋ lymphocyte subsets can reflect their immunity conditions virtually; （2） In early stage after kidney transplantation, if the live-related recipients＇renal function are steady, their absolute counts of CD4^＋ T lymphocyte change regularly after operation, and the range is 582 - 868/μL in CsA group analysed by logistic regression equation, whereas that of FK506 group is 555 - 733/μL; （3） It is helpful to rationalizing the useness of immunosuppressants that we can calculate the plasma concentration according to patients＇ absolute counts of CD4^＋ T lymphocyte in the early stage after transplantation.
出处
《昆明医学院学报》
2008年第5期51-55,共5页
Journal of Kunming Medical College
