不同免疫状态肝移植受者外周血T淋巴细胞亚群及共刺激分子的表达及意义

目的探讨不同免疫状态肝移植受者外周血T淋巴细胞亚群(CD4+、CD8+)、共刺激分子(CD80、CD86)的表达,及其判断肝移植受者不同免疫状态的价值。方法 52例肝移植受者,分为免疫耐受组28例、急性排斥反应组(排斥组)13例、药物不良反应组(药物反应组)11例。采用流式细胞术测定三组患者外周血CD4+、CD8+及CD80、CD86的表达水平,并计算CD4+/CD8+。结果与免疫耐受组和药物反应组比较,排斥组患者外周血CD8+水平较低,而CD4+、CD4+/CD8+、CD80、CD86均较高(P0.05～0.01)。与免疫耐受组比较,药物反应组患者外周血CD8+、CD80、CD86水平明显升高(P0.05～0.01),而CD4+、CD4+/CD8+差异无统计学意义(均为P0.05)。结论免疫T淋巴细胞亚群(CD4+、CD8+及CD4+/CD8+)、CD80、CD86可作为判断肝移植受者免疫状态的指标。

Significance of T cell subsets and co-stimulatory molecules detection in different immune state of liver transplant recipients

Objective To investigate the values of determination of T-lymphocyte subsets and co-stimulatory molecules in evaluating different immune state of liver transplant recipients.Methods Fifty-two recipients were divided into three group：immunotolerant group（n =28）,acute rejection group（n =13）,drug reaction group（n =11）.The expression of CD4＋,CD8＋,CD80 and CD86 in three groups were analyzed by using flow cytometry（FCM）,and CD4＋/CD8＋ ratio was calculated.Results The percentage of CD8＋ cell was significantly lower in the acute rejection group than that of the other two groups.The percentages of CD4＋,CD4＋/CD8＋,CD80 and CD86 were higher in acute rejection group than those in the other two groups（P 0.05-0.01）.The percentages of CD8＋,CD80 and CD86 were higher in the drug reaction group compared with the immunotolerant group（P 0.05-0.01）.There was no significant difference of the percentages of CD4＋,CD4＋/CD8＋ between the drug reaction group and the immunotolerant group（all in P 0.05）.Conclusion The percentages of CD4＋,CD8＋ cells and their ratios as well as the percentage of CD80 and CD86 can be used to determine the immune state of the liver transplant recipients.