肾移植术后早期严重肺部感染患者外周血CD4+T淋巴细胞计数的临床意义 |
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引用本文: | 熊海云,张雷,王立明,康印东,曾力,周梅生,周琳,张玲珍,韩澍,傅尚希,袁清,赵闻雨,陈瑜,朱有华. 肾移植术后早期严重肺部感染患者外周血CD4+T淋巴细胞计数的临床意义[J]. 中华器官移植杂志, 2008, 30(1): 334-337. DOI: 10.3760/cma.j.issn.0254-1785.2009.06.004 |
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作者姓名: | 熊海云 张雷 王立明 康印东 曾力 周梅生 周琳 张玲珍 韩澍 傅尚希 袁清 赵闻雨 陈瑜 朱有华 |
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作者单位: | 第二军医大学长征医院器官移植科,上海,200003;第二军医大学长征医院实验诊断科,上海,200003; |
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摘 要: | Objective To explore the clinical implication of peripheral blood CD4+ T-cell counts in renal allograft recipients with severe pulmonary infection in the early stage after kidney transplantation. Methods From February 2007 to June 2008, we investigated the variation of peripheral blood CD4+ T-cell counts using flow cytometry in 28 cases of severe pulmonary infection 1 ~6 months after kidney transplantation (infection group), and 30 cases (control group) randomly selected that had stable situation and normal kidney function in the same period. Results CD4+ T-cell counts on the day of admission in infection group were significantly lower than in control group (184.1 ±117.5/μl vs. 518.6±232.7/μl, P<0.01 ). In infection group, 5 patients died and 4 of them had obviously declining trends of CD4+ T-cell counts during hospitalization course. Comparing to the day of admission, CD4+ T-cell counts of those survivors in infection group were significantly increased (184.1±117.5/μl vs. 406.5±163.9/μl, P<0.01) when infections were controlled. ROC analysis showed that CD4+ T-cell counts on the day of admission were accurate enough to identify who were susceptible to infection. In detail, the area under the curve (AUC) was 94.9% (P<0.01). CD4+ T-cell counts of 220/μl displayed the minimal misdiagnosis rate. Conclusions The variations of CD4+ T-cell counts are correlated to onset and progression of severe pulmonary infection in the early stage after kidney transplantation. Those who had CD4+ T-cell counts lower than 220/μl were at high risk of pulmonary infection. Direct measure and dynamic analysis of CD4+ T-cell subset have an important role in optimizing treatment and predicting prognosis of severe pulmonary infection in the early stage after kidney transplantation.
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关 键 词: | 肾移植 CD4淋巴细胞计数 肺 感染 |
Clinical implication of peripheral CD4+T cell counts in patients with severe pulmonary infection in the early stage after kidney transplantation |
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Keywords: | Kidney transplantationCD4+ lvmphocyte countLungInfection |
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