肾移植受者术后CD4^+细胞内ATP水平与免疫状态的关系  

Relation of ATP in CD4^+ cells in renal transplant recipients with immune status and clinical application

作　　者：刘杏[1] 黎程[2] 许茹[1] 邵媛[1] 叶欣[1] 罗广平[1] 汪传喜[1] 申升[2] 刘东[2] 

机构地区：[1]广州血液中心,510095 [2]广东省第二人民医院,510317

出　　处：《广州医药》2011年第5期57-60,共4页Guangzhou Medical Journal

基　　金：广州市医药卫生科技项目(2008-YB-140)

摘　　要：目的利用三磷酸腺苷生物发光技术测定移植物血凝素刺激后的CD4+细胞内ATP浓度监测肾移植术后的免疫状态,为临床调整免疫抑制剂用量提供客观具体的数值依据,为减少或停用免疫抑制剂提供理论依据。方法选择年龄18～60岁的肾移植受者100例,利用三磷酸腺苷生物发光技术连续动态的监测100例肾移植受者术后2年内正常状态、感染以及发生排斥反应时的CD4+细胞内ATP浓度。结果肾移植受者术前ATP浓度为(410±105)ng/ml。所有肾移植受者CD4+细胞内ATP浓度术后均下降,于1周左右降至最低,2周左右开始回升,但4周时仍低于术前水平(P<0.01)。术后并发肺部感染时,其CD4+细胞内ATP浓度对比未发生感染者进一步下降,病情加重时下降更加明显,感染控制后有所回升。术后并发急性排斥反应时,其CD4+细胞内ATP浓度对比未发生排斥者明显上升,排斥控制后有所下降。结论 CD4+细胞内ATP浓度可反映机体的整体细胞免疫状态,可以为临床调整免疫抑制用量提供数值依据。Objective We monitored the immune status of renal transplant recipients with ATP boiluminescenae technology,accordingly to provide an objective and specific basis for adjusting the dosage of immunosuppressive agents of clinical,and to provide a theoretical basis for reducing or stopping the use of immunosuppressive agents.Methods Use ATP bioluminescence technology,ATP concentrations in CD4＋ cells in 100 cases of renal transplantation were determined before and 2 years after operation,and at the time of infection or repulsion.Results ATP concentrations in CD4＋ cells of the recipients undergoing renal transplantation were 410±105 ng/ml before operation,reached the lowest about one weeks after operation,then increased slowly on the postoperative week 2,but significantly lower than that pre-transplantation by the fourth week（P 0.01）.In the recipients with postoperative infection,ATP concentrations were decreased,and increased after treatment.In the recipients with postoperative acute rejection,ATP concentrations were increased,and decreased after treatment.Conclusion The determination of ATP in CD4＋ cells could reflect the status of cellular immunity and provide numerical basis for adjusting the dosage of immunosuppressive agents of clinical.

关 键 词：肾移植 免疫监测 三磷酸腺苷 (ATP) 

分 类 号：R699[医药卫生—泌尿科学]