肺移植术后稳定状态受者T淋巴细胞亚群的动态变化分析

目的  分析肺移植术后稳定状态受者1年内T淋巴细胞亚群的动态变化及影响因素。方法  收集行同种异体肺移植手术且术后处于稳定状态的41例受者的临床资料。采用流式细胞术检测受者术前、术后2周及每个月（术后1年内）外周血T淋巴细胞亚群绝对值和比值。分析受者年龄、性别、体质量指数（BMI）、手术方式、原发性移植物功能障碍（PGD）发生情况及原发病对T淋巴细胞绝对值的影响。结果  肺移植术后1年内，CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值及CD4⁺/CD8⁺比值随时间变化差异有统计学意义（均为P < 0.001）。与术前相比，术后12个月CD3⁺、CD3⁺CD4⁺T淋巴细胞绝对值差异均无统计学意义（P=0.659、0.109），CD3⁺CD8⁺T淋巴细胞绝对值升高（P=0.02），而CD4⁺/CD8⁺比值下降，差异有统计学意义（P < 0.001）。肺移植受者的年龄、性别、BMI、手术方式以及术后是否出现PGD对CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值的动态变化无影响（P > 0.05）。肺移植术前原发病对CD3⁺CD4⁺T淋巴细胞的变化无影响，但感染性肺疾病受者术后CD3⁺CD8⁺T淋巴细胞绝对值较高（P < 0.05）。结论  肺移植术后稳定状态受者CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值在术后早期较低，随后逐渐恢复，术后6个月后达到稳态。其动态变化与受者年龄、性别、BMI、手术方式以及术后是否出现PGD无关。

Analysis on dynamic changes of T lymphocyte subsets in recipients with stable graft status after lung transplantation

Objective To analyze the dynamic changes and the influencing factors of T lymphocyte subsets in recipients with stable graft status within 1 year after lung transplantation.Methods Clinical data of 41 recipients with stable graft status after allogeneic lung transplantation were analyzed.The absolute value and ratio of T lymphocyte subsets in peripheral blood from recipients were measured by flow cytometry before operation,2 weeks and each month(within 1 year)after operation,respectively.The effects of age,gender,body mass index(BMI),surgical method,incidence of primary graft dysfunction(PGD)after operation,and primary disease upon the absolute values of T lymphocytes were evaluated.Results Within 1 year after lung transplantation,the absolute values of CD3^+,CD3^+CD4^+,CD3^+CD8^+T lymphocytes and CD4^+/CD8^+ratio were changed over time(all P<0.001).Compared with preoperative values,there was no statistical significance in the absolute values of CD3^+and CD3^+CD4^+T lymphocytes at 12 months after operation(P=0.659,0.109),whereas the absolute value of CD3^+CD8^+T lymphocytes was increased(P=0.02)and the CD4^+/CD8^+ratio was decreased(P<0.001).Age,gender,BMI,surgical method and incidence of PGD after operation exerted no significant effect on the dynamic changes of absolute values of CD3^+CD4^+and CD3^+CD8^+T lymphocytes(all P>0.05).Primary disease before lung transplantation exerted no effect on the changes of CD3^+CD4^+T lymphocytes,whereas the postoperative absolute value of CD3^+CD8^+T lymphocytes was higher in recipients with infectious lung diseases(P<0.05).Conclusions The absolute values of CD3^+,CD3^+CD4^+,CD3^+CD8^+T lymphocytes in recipients with stable graft status after lung transplantation are relatively low in the early stage after lung transplantation,then gradually restore,and stabilize at 6 months after operation.Dynamic changes are not associated with age,gender,BMI,surgical method and incidence of PGD after operation of recipients.