十色流式检测HIV/AIDS患者外周血中T淋巴细胞亚群及活化状态

目的建立十色流式方案检测HIV/AIDS患者外周血中T淋巴细胞亚群及活化状态。 方法按多色流式配色原则,初步确立抗人CD3、CD4、CD8、CD45RA、CD25、CCR7、CD28、CD38、HLA-DR抗体及7-AAD的配色方案。采用1例HIV/AIDS患者外周血PBMC标本进行最适电压调节、荧光补偿设定和FMO对照;设定条件后,检测5例HIV/AIDS患者的外周血样本。 结果建立检测人外周血中T淋巴细胞亚群及活化状态的最优十色流式染色方案,采用此方案检测5例HIV/AIDS患者外周血标本,分析T淋巴细胞各亚群比例及活化程度,发现不同细胞亚群中活化分子HLA-DR、CD38、CD28的表达模式存在显著差异。 结论十色流式方案可检测HIV/AIDS患者外周血中T淋巴细胞亚群及其活化状态操作简便,结果可靠。     

慢性乙型病毒性肝炎患者外周血T淋巴细胞亚群CD27和CD28的表达

目的分析慢性乙型病毒性肝炎患者外周血T淋巴细胞亚群CD27和CD28的表达,初步探讨其分化表型。方法采集分离健康人和慢性乙型病毒性肝炎患者外周血单个核细胞(PBMC),利用多种荧光标记抗体标记细胞表面分子,再用流式细胞仪检测CD8 和CD4 T淋巴细胞表面CD27和CD28分子的表达。结果31例慢性乙型病毒性肝炎患者CD8 CD27 CD28 T细胞占CD8 T细胞(41.13±24.89)%,低于28例健康对照组的(71.93±14.47)%(P<0.05)。而CD8 CD27-CD28-T细胞占CD8 T细胞(42.16±10.98)%,显著高于健康对照组的(9.16±5.24)%(P<0.01)。慢性乙型病毒性肝炎患者CD4 CD27 CD28 T细胞(80.89±7.93)%和健康对照组(83.17±8.31)%比较,差异无统计学意义。结论健康人外周血T淋巴细胞以CD27 CD28 早期分化表型为主。而慢性乙型病毒性肝炎患者外周血中不同的亚群分化特征又有所不同,CD4 T淋巴细胞的分化表型仍然以CD27 CD28 早期分化表型为主,而CD8 T淋巴细胞中早期分化表型明显减少,晚期分化表型(CD27-CD28-)显著增加。     

三色荧光标记鉴定早孕蜕膜及外周免疫细胞组成

目的建立早孕妇女蜕膜免疫细胞高纯度的分离方法,流式细胞术多色荧光直接标记分析早孕蜕膜及外周血主要免疫细胞的构成比。方法经胶原酶消化、Percoll密度梯度离心、短期培养结合的方法分离纯化蜕膜免疫细胞,采用三色、双色及单色荧光直接标记流式细胞术分别检测早孕妇女和对照组中蜕膜、外周血CD3-CD56+CD16-和CD3-CD56+CD16+NK细胞、NKT和γδT细胞、T细胞和单核细胞的阳性率。结果与外周血相比,蜕膜免疫细胞以CD3-CD56+CD16-数量最多,约占免疫细胞总数的(67.02±18.33)%,T细胞占(11.05±7.22)%,单核细胞占(5.28±0.29)%,NKT细胞占(2.35±1.62)%;早孕妇女外周血T淋巴细胞较正常生育期妇女明显下降(P<0.05),而早孕妇女外周血中NK细胞、NKT细胞、单核细胞数量与对照组相比无显著差别。结论早孕妇女蜕膜中具有与外周血不同的免疫细胞组成,应用多色荧光标记的流式细胞术能够简单、直接地鉴定各免疫细胞亚群。     

泛发性白癜风患者外周血体外活化后T细胞表达CD154水平的研究

目的:比较泛发性白癜风患者和正常人外周血T细胞体外活化后表达的CD154水平。方法:活化前及体外活化6h后,分别对泛发性白癜风患者及对照组外周血标记CD3,裂解红细胞,获取外周血有核细胞后标记CD154,流式细胞仪检测并比较两组CD3~+T细胞CD154表达水平。结果:体外活化6h后,泛发性白癜风患者外周血CD3~+T细胞CD154表达水平明显高于对照组(P0.05)。结论:外周血T细胞过度表达的CD154可能通过诱导自身抗体产生及增加炎性细胞因子等途径参与白癜风的发病机制。     

结直肠癌患者外周血Th1和Th2细胞的检测与临床意义

目的 研究结直肠癌患者外周血CD4+T细胞亚群Th1和Th2细胞的比例以及相关特异性转录因子与细胞因子的表达水平,并观察其与临床分期之间的关系.方法 43名结直肠癌患者(肠癌组)与30名健康体检志愿者(对照组)作为研究对象.结直肠癌患者外周血Th1和Th2细胞占CD4+T细胞的比例运用流式细胞技术进行检测.采用实时荧光定量聚合酶链反应(quantitative Real-time PCR),检测外周血Th1/Th2细胞亚群特异性转录因子的相对基因表达量.血浆细胞因子的表达水平使用液相芯片技术方法定量检测.结果 肠癌组外周血Th2细胞占CD4+T细胞的比例和Th2细胞特异性转录因子GATA-3的mRNA表达量均显著高于对照组(P<0.05).肠癌组外周血Th1细胞特异性转录因子T-bet的mRNA表达量显著低于对照组(P<0.05),但Th1细胞占外周血CD4+T细胞的比例与对照组差异无统计学意义(P>0.05).血浆TNF-α、IL-1β和IL-15表达水平组间无显著差异(P>0.05).结直肠癌患者血浆IFN-γ、IL-4和IL-6的表达水平与病程分期有关(P<0.05).结论 结直肠癌患者外周血中Th1细胞比例变化不明显而Th2细胞比例明显升高.结直肠癌患者血浆细胞因子的不平衡表达可作为机体免疫状态转换与病情判断的指标.     

肝癌患者外周血CD4~+CD25~+调节性T细胞的变化及其意义

目的 探讨应用流式细胞术检测肝癌患者外周血中CD4~+CD25~+调节性T细胞的变化及意义.方法 应用三色免疫荧光流式细胞仪测定37例肝癌患者及30例肝硬化患者外周血T细胞亚群CD4~+CD25~+/CD~+比值.采用酶联免疫吸附试验(ELISA)法检测外周血中转化生长因子β1(TGF-B1)的表达水平.结果 肝癌患者外周血CD4~+CD25~+/CD4~+比值较肝硬化患者显著增高,两者比较差异有统计学意义(P<0.05);肝癌患者外周血中CD4~+CD25~+T细胞水平与肝癌原发肿瘤的大小、TGF-βl呈正相关(P<0.05).结论 肝癌患者外周血中CD4~+CD25~+调节性T细胞增多,对肝癌患者具有免疫抑制作用.     

乳腺癌患者外周血中T细胞亚群与淋巴结转移和组织学分级的关系

目的:探讨乳腺癌患者外周血中T细胞亚群的变化及其与淋巴结转移和组织学分级的关系。方法:用流式细胞术检测86例乳腺癌患者以及20例乳腺腺病患者外周血T细胞亚群的百分率。结果:乳腺癌患者外周血总T细胞与CD4~+T细胞百分数与腺病患者无统计学差异(均P0.05),但CD8~+T细胞百分数低于腺病患者(P0.05)。乳腺癌患者中,淋巴结转移者CD4~+T细胞百分数高于无淋巴结转移者(P0.05);CD8~+T细胞百分数随组织学分级增加而升高(P0.05)。结论:乳腺癌患者存在细胞免疫功能紊乱,外周血中CD4~+T细胞、CD8~+T细胞比例的变化分别与淋巴结转移、组织学分级密切相关。监测外周血T细胞亚群的变化,有助于病情及预后的判断。     

胃癌患者外周血调节性T细胞的变化及其意义

目的 探讨胃癌患者外周血中CD4+CD25+T淋巴细胞、CD8+CD28-T淋巴细胞比例的变化及其临床意义.方法 采用流式细胞技术检测30例胃癌患者外周血中CD4+CD25+T淋巴细胞、CD8+CD28-T淋巴细胞玎分比,对照组为30例慢件胃炎患者.结果 胃癌患者外周血中CD4+CD25+调节性T细胞占T淋巴细胞的百分比为8.7%±1.3%,与胃炎患者相比差异无统计学意义.胃癌患者外周血中CD8+CD28-调节性T细胞占T淋巴细胞的百分比为30.3%±3.3%,明显高于胃炎患者的20.3%±2.7%.外周血中CD4+CD25+T淋巴细胞、CD8+CD28-T淋巴细胞百分比与胃癌淋巴结转移、病理分型无明显相关性.结论 外周血中调节性T细胞在胃癌发展中可能发挥一定作用.     

活化的脐血T淋巴细胞胞内细胞因子特性研究

目的通过对人脐血中CD4+和CD8+T淋巴细胞经特异抗原刺激后,胞内细胞因子γ-IFN和IL-4分泌水平的研究,探讨人脐血干细胞移植后急、慢性移植物抗宿主病(GVHD)发生低下的可能机制.方法15份脐血和15份健康成人外周血中T淋巴细胞在莫能霉素存在的情况下,体外经十四烷酰拂波醇乙脂和离子霉素刺激后,分别进行CD4-FITC、CD8-FITC荧光单抗染色和γ-IFN-PE、IL-4-PE荧光单抗胞内染色,最后进行流式细胞仪分析.结果脐血中CD4+Th细胞和CD8+Tc细胞胞内γ-IFN分泌水平均明显低于成人外周血中CD4+和CD8+T细胞,而脐血CD8+T细胞胞内IL-4分泌水平与成人外周同类细胞差异无显著性.结论人脐血中T淋巴细胞受特异抗原刺激后,胞内不能产生正常的Th1/Tc1样细胞因子谱,即活化的脐血T淋巴细胞Th1/Tc1样反应低下,这可能是脐血移植后GVHD发生低下的原因之一.     

慢性特发性荨麻疹患者外周血T及Th淋巴细胞亚群的表达

目的：探讨慢性特发性荨麻疹患者外周血T及辅助性T淋巴细胞（Th）亚群的表达及其在慢性特发性荨麻疹发病机制中的作用。方法：采用流式细胞术检测经四色荧光抗体染色的慢性特发性荨麻疹患者及正常对照外周血CD3^＋、CD4^＋、CD8^＋T淋巴细胞数及CD4^＋／IFN-γ’（Th1）、CD4^＋／IL-4^＋（Th2）细胞含量。结果：慢性特发性荨麻疹组外周血CD3^＋T淋巴细胞数无明显变化、CD4^＋T淋巴细胞数、CD8^＋T淋巴细胞数均降低;CD4^＋／CD8^＋比值增高,差异有统计学意义（P〈0．01）。慢性特发性荨麻疹患者外周血Th1细胞含量、Th1／Th2比值均明显低于正常对照组（P〈0．01,P〈0．05）,Th2细胞含量高于正常对照组（P〈0．01）。结论：慢性特发性荨麻疹患者外周血存在着T及Th淋巴细胞亚群分化失衡,这可能为慢性特发性荨麻疹发病的机制之一。     

皮肌炎活检特点及免疫状态分析

［摘要］ 目的 探讨初发皮肌炎（dermatomyositis，DM）的临床及肌肉活检特征及治疗前后淋巴细胞亚群的影响。方法 回顾性分析27例初发皮肌炎患者临床特征、肌电图及MRI结果；全部患儿均进行右侧大腿股四头肌肌肉活检，记录组织化学（HE、COX、SDH）染色后光镜下观察肌纤维形态、电镜及免疫组化后肌纤维膜特点；观察治疗12周前后PLT、CRP、WBC、免疫球蛋白IgG、IgA、IgM、IgE和CD3+T细胞、CD4+T细胞、CD8+T细胞、CD19+B细胞、CD16+56?NK细胞的变化。结果 治疗12周后CD19+B细胞的比例较基线降低（P<0.05），CD8、CD3+T细胞比例较基线升高、治疗前后CD16+56?NK细胞较基线变化不明显（P>0.05），免疫球蛋白IgG、IgM、IgA较基线下降（P<0.05），27例患儿进行了MRI（右侧大腿）检测，所见双侧臀部、大腿、膝部及双侧小腿上端肌肉、肌肉间隙及皮下脂肪层弥漫性异常信号影，肌电图均显示所测肌肉进行性肌源性损害。25例肌酶明显升高，光镜下均见到个别肌纤维坏死，局部见束周萎缩，未见胞浆内脂滴或糖原空泡，未见破碎红纤维或镶边空泡，肌束膜和肌内膜纤维脂肪组织增生不明显，炎症细胞不明显，COX酶活性正常，Dystrophin提示肌纤维膜呈阳性表达，表达均匀、连续。电镜下肌细胞大小不等，呈现萎缩、变性、坏死改变，其中2例（7.4%）肌酶正常，肌纤维Dystrophin表达可疑减弱（图2），1例（3.7%）COX染色示少数肌纤维酶活性减低，且SDH/COX见少数蓝纤维（图3），1例（3.7%）光镜下未见典型束周萎缩（图4），电镜显示脂滴增多。结论 皮肌炎光镜下均见到个别肌纤维坏死，局部见束周萎缩，MRI 检查能灵敏且无创地显示JDM 患者的肌肉病变。B、T细胞的免疫紊乱参与了皮肌炎发病，同时也可作为皮肌炎治疗疗效判别的指标。     

肾移植术后测定外周血CD3/HLA-DR及CD3/CD(16+56)的临床意义

目的探讨肾移植患者术后外周血ＣＤ３／ＨＬＡ－ＤＲ及ＣＤ３／ＣＤ（１６＋５６）的变化及其意义。方法提取患者的外周血淋巴细胞,加入双荧光标记的鼠抗人单克隆抗体ＣＤ３／ＣＤ（１６＋５６）、ＣＤ３／ＨＬＡＤＲ,流式细胞分析仪进行测定。结果术前患者的ＣＤ＋３／ＣＤ＋（１６＋５６）、ＣＤ－３／ＣＤ＋（１６＋５６）及ＣＤ－３／ＨＬＡＤＲ＋高于健康人,而ＣＤ＋３／ＣＤ－（１６＋５６）和ＣＤ＋３／ＨＬＡＤＲ－低于健康人;术后３天肾功能稳定者的全部淋巴细胞亚群下降,尤以ＣＤ＋３／ＣＤ＋（１６＋５６）为著;术后排斥者的ＣＤ－３／ＣＤ＋（１６＋５６）、ＣＤ＋３／ＣＤ＋（１６＋５６）、ＣＤ－３／ＨＬＡＤＲ＋及ＣＤ＋３／ＨＬＡＤＲ＋较稳定者显著升高,而急性肾小管坏死者的上述４个指标异常增高,是排斥组的２倍。结论术后动态测定ＣＤ３／ＨＬＡＤＲ和ＣＤ３／ＣＤ（１６＋５６）有助于急性排斥和急性肾小管坏死的早期诊断及鉴别诊断,对及时治疗和抗排斥疗效的评价具有一定意义     

Lymphocyte subsets in renal allograft recipients with chronic hepatitis C virus infection.

BACKGROUND: The pathogenetic mechanisms of chronic hepatitis C virus (HCV) infection in renal allograft recipients are not well established. This study aimed to examine the relationship between altered immune status and HCV-related liver disease, by determining the changes in peripheral blood lymphocyte and natural killer (NK) cell subsets in these subjects. METHODS: Peripheral blood lymphocyte, NK cell and activation markers were detected by flow cytometry in renal allograft recipients with (TpC+) or without (TpC-) HCV infection, and compared with age- and sex-matched patients with post-transfusional chronic HCV infection (TfC+) and healthy controls. RESULTS: CD19+ cells were reduced in renal allograft recipients compared with controls. TpC+ subjects had increased CD3+CD8+ cells compared with controls, and increased CD3+DR+ cells but reduced CD4+ CD38+ and CD3-CD16/56+ cells compared with controls as well as TfC+ patients. TfC+ patients and controls had similar numbers and proportions for the lymphocyte subsets and NK cells. Chronic liver disease in HCV-infected renal allograft recipients was associated with increased CD3+CD16/56+ cells but reduced CD4+CD38+ cells. Reduction of CD3-CD16/56+ cells was noted in TpC+ subjects without liver disease. Yet among post-transfusional (TfC+) subjects this was associated with chronic hepatitis. CONCLUSIONS: Peripheral blood suppressor/cytotoxic T lymphocytes are increased, whereas activated helper/inducer T lymphocytes and NK cells are reduced, in renal allograft recipients with HCV infection. Increased non-MHC-restricted cytotoxic T cells and reduced NK cells are associated with the presence or absence of liver disease respectively. These data suggest that immune mechanisms are important in the pathogenesis of chronic hepatitis C after renal transplantation.     

Lymphocytes subsets in the course of continuous ambulatory peritoneal dialysis (CAPD)

BACKGROUND: We studied lymphocyte subset counts in comparison with normal subjects in order to clarify the abnormalities of cellular immune responses in uremic patients undergoing continuous ambulatory peritoneal dialysis (CAPD). METHODS: The study included 37 CAPD patients and 45 normal individuals, as the control group. For the study, CAPD patients were divided into four groups depending on duration of replacement therapy. Group I consisted of patients treated for 0-6 months (n=6), group II for 6-12 months (n=6), group III for 13-24 months (n=16), and group IV for more than 25 months (n=9). Flow cytometry was used for estimation of lymphocyte subsets (determination of CD2, CD3, CD3+/CD4+, CD3+/CD8+, CD3-/16+56+, CD19, CD4/CD8). RESULTS: Our patients started CAPD with decreased lymphocyte subset counts, slightly above the normal range (excluding CD3 -/16+56+, CD2). After 6 months of CAPD therapy, an increase in CD4/CD8 ratio was observed and all examined lymphocyte subset counts decreased (excluding CD2). In patients on CAPD for more than 25 months, CD3+/CD4+, CD19 counts were below the normal range, CD3 -/16+56+ exceeded the upper limit of normal range and at the same time mean total lymphocyte count (TLC) was maintained in the normal range. CONCLUSIONS: We recommend lymphocyte subset determinations for detection of immune abnormalities in the course of CAPD treatment.     

儿童肾病综合征T细胞亚群检测的临床意义

目的：探讨儿童原发性肾病综合征（NS）T细胞亚群检测的临床意义。方法：对25例NS活动期和缓解期患儿应用流式细胞仪检测T2细胞亚群的变化。结果：NS活动期组CD3^ ,CD4^ ,CD4^ /CD8^ 比值，NK[CD(16 56)]^ 细胞均明显低于缓解期组（P＜0．01）和对照组（P＜0．01）。结论：说明NS细胞免疫功能减低，T细胞亚群检测可作为肾病综合征活动指标之一。     

右美托咪定联合羟考酮对胃癌根治术患者免疫功能的影响

目的观察右美托咪定联合羟考酮对胃癌根治术患者免疫功能的影响。 方法选择新疆维吾尔自治区人民医院2015年6月至2016年3月全麻下行胃癌根治术患者60例,用随机数字表法将其分为2组：羟考酮组（O组）和右美托咪定联合羟考酮组（DO组）,每组30例。所有患者行静脉全麻,静脉泵注异丙酚4~6 mg·kg^-1·h^-1,靶控输注瑞芬太尼3~4 μg/L,术毕前30 min静脉注射羟考酮0.04 mg/kg;DO组诱导后以0.5 μg·kg^-1·min^-1的速度静脉泵注右美托咪定至术毕前30 min。术毕采用经静脉自控镇痛。于术前（T0）、术毕（T1）、术后4 h（T2）和8 h（T3）时抽取静脉血标本,用流式细胞仪测定T淋巴细胞亚群CD3+、CD4+、CD8+和NK细胞CD16+/CD56+水平,计算CD4+/CD8+比值。记录术后镇痛VAS评分、恶心呕吐、呼吸抑制、头痛等不良反应发生情况。 结果与T0时比较,两组T1、T2时CD3+、CD4+、CD4+/CD8+比值、NK细胞CD16+/CD56+水平降低,CD8+水平升高（P<0.01）。与O组比较,DO组T1、T2时CD3+、CD4+、CD4+/CD8+比值和NK细胞CD16+/CD56+水平升高（P<0.01）,不良反应发生率差异无统计学意义。 结论右美托咪定联合羟考酮对胃癌根治术患者术后免疫功能抑制程度较单纯羟考酮减轻。     

Blood lymphocyte subsets in ATG-treated and allografted rats

A single dose of rabbit antithymocyte globlin (ATG) was given as the sole immunosuppressive therapy in a model of strong MHC barrier rat heart allotransplantation. PVG/c hearts transplanted to Wistar/Kyoto (WKy) rats resulted in long-term surviving (LTS) grafts and cellmediated lympholysis (CML) unresponsiveness in 50% of the animals. The effects of ATG treatment on the peripheral blood lymphocyte subsets were studied by flow cytometry. The absolute T-lymphocyte levels decreased to less than 5% and were normalized after 2 weeks. CD8-positive cells were normalized within 1 week, whereas CD4- and CD5-positive cells remained low. Rats with LTS grafts had low levels of all T-lymphocyte markers, especially the CD4- and CD5-positive cells. Rats rejecting their grafts showed an eightfold increase in levels of CD8- and CD5-positive lymphocytes and a twofold increase in levels of CD4-expressing lymphocytes. It is concluded that ATG treatment causes the immediate elimination of large lymphoid populations as well as long-lasting immunomodulation detectable in peripheral blood.     

系统性红斑狼疮患者不同巨细胞病毒感染状态淋巴细胞亚群分析

目的探讨系统性红斑狼疮（SLE）患者不同巨细胞病毒（CMV）感染状态淋巴细胞亚群的特征，为临床诊断系统性红斑狼疮提供依据。 方法选取2016年6月至2019年6月于南京中医药大学附属张家港医院的SLE住院患者共96例，其中合并巨细胞病毒血症患者18例（巨细胞病毒血症组）、巨细胞病毒病患者50例（巨细胞病毒病组）和无CMV感染者28例（对照组）。获取3组患者的一般资料、常规实验室指标、CMV DNA拷贝数和外周血淋巴细胞亚群计数；并比较CMV感染者的上述指标，分析不同CMV感染状态下淋巴细胞亚群的特征。 结果巨细胞病毒血症组患者和巨细胞病毒病组患者的红细胞沉降率（t =-0.141、P = 0.025，t =-0.194、P = 0.003）CRP水平显著高于对照组（t =-0.563、P = 0.010），巨细胞病毒病组患者CRP（t =-0.854、P = 0.006）、环磷酰胺治疗例数（χ² =-6.139、P = 0.013）、血CMV DNA拷贝数（t =-0.355、P = 0.041）均显著高于巨细胞病毒血症组。巨细胞病毒血症组患者与对照组患者总淋巴细胞计数、CD3⁺ T细胞、CD3⁺CD4⁺ T细胞、CD3⁺CD8⁺ T细胞、CD19⁺ B细胞和CD56⁺CD16⁺ NK细胞计数差异均无统计学意义（P均> 0.05）。巨细胞病毒病患者总淋巴细胞计数（t = 0.933、P < 0.001）、CD3⁺ T细胞（t = 0.177、P = 0.018）、CD3⁺CD4⁺ T细胞（t = 0.207、P < 0.001）、CD3⁺CD8⁺ T细胞（t = 0.169、P < 0.001）和CD19⁺ B细胞（t = 0.320、P = 0.023）显著低于对照组患者。 结论淋巴细胞计数减低（尤其是CD4⁺ T细胞计数减低）常见于SLE患者伴发CMV感染中常见，是系统性红斑狼疮患者CMV感染诊断的潜在生物标记物。     

外周血淋巴细胞亚群监测在甲状腺动脉栓塞治疗Graves病中的意义

目的探讨甲状腺动脉栓塞治疗Graves病（GD）对外周血淋巴细胞亚群的影响。方法对41例临床确诊的Graves病进行甲状腺动脉栓塞治疗,术后随访3～54个月,依据患者症状、体征和甲状腺功能等指标观察疗效。分别于术前、术后1个月、3个月、6个月、12个月及36个月测定外周血淋巴细胞亚群,观察GD患者栓塞治疗前后淋巴细胞的动态变化。结果GD外周血CD3^＋CD8^＋细胞比率减少,CD4^＋/CD8^＋比值增高。CD16^＋CD56^＋细胞于术后1、3个月均高于术前,6个月后降低并接近正常水平;术后CD3^＋CD8^＋细胞逐渐增高,1年后达到正常水平;CD4^＋/CD8^＋比值于治疗6个月后降至正常水平。复发组CD16^＋CD56^＋细胞、CD3^＋CD8^＋细胞比率、CD4^＋/CD8^＋比值与术前比较差异无统计学意义。结论GD患者体内存在免疫功能紊乱,可以检测到外周血淋巴细胞亚群的异常改变。甲状腺动脉栓塞治疗有效者,外周血淋巴细胞亚群的异常得以缓慢纠正,而复发者则无显著改善。说明介入治疗GD可从免疫调节的水平发挥有效的治疗作用,测定外周血淋巴细胞亚群对于判断疗效有一定意义。     

Long-term evolution of lymphocytes subsets after induction therapy based on continuous versus discontinuous administration of anti-thymocyte globulins in renal-transplant patients

The aim of our retrospective study was to assess the long-term evolution of lymphocyte subsets after two modes of administration of anti-thymocyte globulin (ATG) after renal transplantation. METHODS: Before 1993, patients (group I, n = 93) received fixed doses of RATG (1 mg/kg per day) for 8 consecutive days. Thereafter, RATG was either continued at the same dose for 15 days, in cases of delayed graft function, or was infused every other day at the same dose until the serum creatinine level became <150 micromol/L. After 1993, patients (group II, n = 66) received RATG at full dose (1 mg/kg per day) during the first 3 days and, thereafter, doses were adapted to target a CD2 T-cell count <50/mm3. RATG cumulative dose was significantly higher among group I than group II (9.7 +/- 4.5 versus 7.4 +/- 3.2 mg/kg, P = .0002). RESULTS: In both groups, total lymphocyte and T lymphocyte subset (CD4, CD8, CD2, CD3) counts decreased significantly during the first month after transplantation, increasing slowly between the first month and the third year posttransplantation. Thereafter it rose rapidly, which was greater in group II. At last follow up, total lymphocyte, T lymphocyte subsets and NK cell counts were similar to those observed before transplantation. At all monitoring times, T lymphocyte, B lymphocyte, and NK cell counts were similar in both group, except for the total lymphocyte count at 6 months and CD4 T lymphocyte count at 1 year, which were significantly higher in group II compared to group I. CONCLUSION: Induction therapy based on continuous or discontinuous administration of ATG is associated with profound depletion of T, B, and NK cells during the first 3 years, followed by a progressive reconstitution of the lymphocyte pool after 5 years.