肾移植术后测定外周血CD_3/HLA-DR及CD_3/CD_(16+56)的临床意义  

Determination of CD 3/HLA DR and CD 3/CD (16+56) in peripheral blood in the patients with kidney transplantation and its implication

作　　者：李香铁[1] 李慎勤[1] 刘少鸽[1] 杨德安[1] 郝俊文[1] 王洪伟[1] 韩玮[1] 刘仰东[1] 张海滨[1] 尹格平[1] 

机构地区：[1]济南军区总医院泌尿外科

出　　处：《中华器官移植杂志》1999年第1期27-29,共3页Chinese Journal of Organ Transplantation

摘　　要：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。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.

关 键 词：肾移植 淋巴细胞 单克隆抗体 抗排斥反应 

分 类 号：R699.2[医药卫生—泌尿科学]