单倍体相合造血干细胞移植术后早期肺部感染患者CD4~+T细胞功能的分析

为探讨单倍体相合造血干细胞移植(hi-HSCT)术后早期肺部感染患者的免疫状态,监测25例患者在移植前及移植术后6个月内不同时间点CD4+T细胞功能,了解其在肺部感染组和非肺部感染组患者间的差异,为调整免疫抑制剂用量提供参考,以减少肺部感染的发生。采用ImmuKnow方法检测患者外周血CD4+T细胞的ATP含量,评估T细胞功能。结果表明:移植后早期肺部感染组患者移植前CD4+T细胞ATP含量较低,为(179.88±65.41)ng/ml,移植后1个月降至(172.69±118.81)ng/ml,其后逐渐增高,但移植后3个月仍未达正常水平,为(218.15±124.26)ng/ml,移植后6个月升至正常,为(313.42±116.29)ng/ml。无肺部感染组患者移植前CD4+T细胞ATP含量也偏低,为(210.44±94.71)ng/ml,移植后1个月降至(193.66±133.69)ng/ml,其后逐渐上升,移植后3个月升至(355.02±43.38)ng/ml,移植后6个月为(355.73±93.85)ng/ml。结论:移植前后CD4+T细胞ATP含量均可提示移植后感染并发症的发生,可作为临床经验性抗生素应用的参考指标。

Analysis of CD4+ T Cell Function in Patients Suffered from Pulmonary Infection in the Early Phase after Haploidentical Hematopoietic Stem Cell Transplantation

This study was purposed to investigate the immune state of the patients suffered from pulmonary infection within 6 months after haploidentical hematopoietic stem cell transplantation（hi-HSCT）.Adenosine triphosphate（ATP） value in CD4^＋ T cells was measured by ImmuKnow method to assess the function of the lymphocytes in peripheral blood of 25 patients at 6 months after hi-HSCT.The results showed that the ATP level in CD4^＋ T cells of the patients suffered from pulmonary infection was（179.88±65.41） ng/ml before transplantion,（172.69±118.81） ng/ml at 1 month,（218.15±124.26） ng/ml at 3 months,（313.42±116.29） ng/ml at 6 months after transplantion.The ATP level in CD4^＋ T cells of the patients without pulmonary infection was（210.44±94.71） ng/ml before transplantion,and decreased to（193.66±133.69） ng/ml at 1 month and increased gradually to（355.02±43.38） ng/ml at 3 months,（355.73±93.85） ng/ml at 6 months after transplantion.It is concluded that the low ATP value in CD4^＋ T cells in patients prior and post hi-HSCT may suggest probability of occurrence for infections,ATP value in CD4^＋ T cells may be used as a reference indicator for clinical empirical use of antibiotics.