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

Determination of CD3/HLA-DR and CD3/CD(16+56)in peripheral blood in the patients with kidney transplantation and its implication

Objective To investigate the changes in the activated T cell populations CD 3/HLA DR and CD 3/CD (16 56) in peripheral blood in the patients with kidney transplantation. Methods The lymphocytes from the peripheral blood in the patients in different periods after kidney transplantation were immunologically labeled by dual color fluorescent monoclonal antibodies CD 3/HLA DR and CD 3/CD (16 56) . CD 3/HLA DR and CD 3/CD (16 56) were determined by using flow cytometry (FCM). Results The levels of CD 3/CD (16 56) , CD - 3/CD (16 56) and CD - 3/HLA DR in the patients before renal transplantation were higher than in the normal subjects, while the CD 3/CD - (16 56) and CD 3/HLA DR - were lower. Three days after transplantation, the T cells and T cell subsets were decreased in the getting well patients, and the CD 3/CD (16 56) were the most obvious among them. The levels of CD - 3/CD (16 56) , CD 3/CD (16 56) and CD - 3/HLA DR were significantly increased in the group with rejection. The four parameters mentioned above in patients with acute nephrotubal necrosis were all abnormally increased as two times as those of the group with rejection. Conclusion The dynamic determination of CD 3/HLA DR and CD 3/CD (16 56) is helpful to the early diagnosis and differential diagnosis of acute kidney rejection from acute nephrotubal necrosis, and is of some important for the treatment of rejections and the evaluation of the curative effects of antirejection.