肾移植术后外周血自然杀伤细胞的CD158b表达及意义

目的探讨肾移植术后外周血自然杀伤细胞(NK细胞)的CD158b表达及意义。方法测定62例患者肾移植前、术后第1d、术后第7d、肾功能正常时以及疑有排斥反应时外周血NK细胞的CD158b表达水平。结果62例中,术后38例肾功能恢复正常,观察期内无排斥反应发生,移植前后外周血CD3-CD16/CD56 细胞(NK细胞)及CD3-CD16/CD56 CD158b 细胞稳定,NK细胞中CD158b 细胞的比例也稳定;24例术后7～14d发生急性排斥反应,其外周血CD3-CD16/CD56 细胞呈上升趋势,CD3-CD16/CD56 CD158b 细胞呈下降趋势,NK细胞中CD158b 细胞的比例也呈下降趋势,经单因素方差分析,各指标在不同测定时点的差异均有统计学意义(P<0.05,P<0.01)。结论干扰NK细胞表达CD158b的因素较少,在临床上做出排斥反应诊断前,患者外周血中NK细胞的CD158b表达即呈下降趋势,因此术后监测NK细胞的CD158b表达可为评价患者的免疫状况提供依据。

Expression of CD158b in peripheral blood NK cells after kidney transplantation

Objective To investigate the expression of CD158b in NK cells after allogeneic kidney transplantation.Methods In 62 patients with allogeneic kidney transplantation, blood samples were collected on the day before operation, first, 7th day after operation, the moment the graft (reco)-(vered) and the acute rejection occurred. The expression of CD158b was detected in peripheral blood NK cells. The ratio of CD3~-CD16/56~ CD158b~ was measured.Results There were 38 patients without acute rejection during the whole transplantation period. The ratio of CD3~-CD16/56~ cells and CD3~-CD16/56~ CD158b~ cells were stable before and after the transplantation. Twenty-four patients experienced acute rejection post-transplantation. The ratio of CD3~-CD16/56~ cells was increased significantly after acute rejection, the ratio of CD3~-CD16/56~ CD158b~ cells decreased significantly, and the percentage of CD3~-CD16/56~ CD158b~ cells of total NK cells decreased significantly.Conclusion There are not too much factors interfering with the expression of CD158b in NK cells, and the ratio of CD3~-CD16/56~ CD158b~ cells had already decreased significantly before the clinical diagnosis of (acute) rejection. Monitoring of CD158b in NK cells is more accurate and sensitive for the evaluation of immune state.