肾移植后排斥与感染中细胞免疫功能的监测  

Immune function monitoring for rejection and infection after renal transplantation

作　　者：王庆华[1] 尚乐乐[1] 谌泰春[1] 王瑾[1] 唐敏英[1] 吴琳[1] 谭建明[1] 

机构地区：[1]解放军南京军区福州总医院泌尿外科,福建省福州市350025

出　　处：《中国组织工程研究》2013年第5期811-816,共6页Chinese Journal of Tissue Engineering Research

基　　金：福建省科技创新平台建设计划(2010Y2006)~~

摘　　要：背景:Cylex ImmuKnow检测方法是惟一得到FDA认可的检测移植受者细胞免疫功能的方法,它直接反映细胞免疫的功能,具有灵敏度高、特异性强,结果量化等优点。目的:通过对肾移植后患者监测细胞免疫功能iATP值(intracellular adenosine triphosphatei),分析细胞免疫功能与肾移植术后排斥或感染的关系。方法:140例肾移植受者采用ImmuKnowTM-Cylex方法检测细胞免疫功能,收集数据结合患者临床状态分为排斥组18例,感染组35例与稳定组87例,同时收集61份健康人群血样检测细胞免疫功能数据作对照。分析细胞免疫功能与肾移植患者移植后发生排斥与感染的关系。结果与结论:细胞免疫功能iATP值检测结果显示,感染组患者有71.4%(n=25)分布在低免疫区,同比对照组、稳定组与排斥组比例明显增高(P<0.05)。感染组iATP值显著低于其他3组。说明感染与细胞免疫功能低下两者具有明显的相关性,细胞免疫功能测定对监测肾移植后感染具有显著意义。提示ImmuKnowTM-Cylex方法测定细胞免疫功能为肾移植后并发感染的诊断与治疗提供可靠客观依据,但与肾移植后排斥反应的发生未见明显的相关性,有待于大样本的实验证实。BACKGROUND： Cylex ImmuKnow is the first and only U S Food and Drug Administration-cleared blood test to measure immune cell function, it can reflect the immune function of the cells directly, which is a valuable tool with good qualities of high sensitivity and specificity. OBJECTIVE： To investigate the correlation between immune cell function and the rejection and infection after renal transplantation through monitoring of immune function intracellular adenosine triphosphatei value. METHODS： We collected 140 renal transplant patients. The immune cell function levels were measured by ImmuKnowTM-Cylex. The patients were divided into three groups according to clinical status of patients, namely, rejection group （n=18）, infection group （n=35） and stability group （n=87）. In addition, the cellular immune function data in the blood of 61 samples from healthy people were collected as control group. Then the correlation of the immune cell function and infection to rejection after renal transplantation was analyzed. RESULTS AND CONCLUSION： The measurement of intracellular adenosine triphosphatei value showed that about 71.4% （n=25） patients in the infection group distributed in the low immune response zone, and the percentage in the infection group was significantly higher than that in the other three groups （P 0.05）. The intracellular adenosine triphosphatei value in the infection group was significantly lower than that in the other three groups. That indicated that the infection was correlated with low cellular mediated immune function, and the detection of immune cell function played an important role in monitoring the infection after renal transplantation. The immune cell function monitoring with ImmuKnowTM-Cylex assay provides reliable and objective basis for the diagnosis and treatment of infection after renal transplantation, but it has no correlation with the rejection after renal transplantation, and that needs further investigation with a large-sample experiment.

关 键 词：器官移植 肾移植 细胞免疫功能 免疫 细胞免疫 排斥反应 感染 iATP值 ImmuknowTM 省级基金 

分 类 号：R318[医药卫生—生物医学工程]