异基因造血干细胞移植后患者胸腺输出功能研究  

Study on thymic output function in post-allogeneic hematopoietic stem cell. transplantation patients

作　　者：赵林俊[1] 孙丽华[1] 龙霞[2] 许蕾[1] 姚志娟[1] 王钧[1] 孟庆祥[1] 

机构地区：[1]北京大学深圳医院血液科,518036 [2]北京大学深圳医院中心实验室,518036

出　　处：《白血病．淋巴瘤》2013年第3期161-164,共4页Journal of Leukemia & Lymphoma

基　　金：深圳市科技计划项目（201202009）

摘　　要：目的 采用改良的信号连接T细胞受体重排删除环（sjTREC）定量方法检测异基因造血干细胞移植患者胸腺输出功能并分析其影响因素。方法 采用实时荧光定量聚合酶链反应（PCR）技术检测26例异基因造血干细胞移植患者各时期（移植前及移植后14 d、28 d、3个月、6个月、9个月、1年、1.5年、2年、2.5年、2.5年以上）外周血sjTREC水平，分析胸腺输出功能及影响因素。以24名健康体检者sjTREC作为对照。结果 健康体检者外周血Log（sjTREC copies／ml）为3.74±0.26，与年龄呈负相关（r＝-0.65，P＜0.01），与性别无明显相关性；患者移植前外周血Log（sjTREC copies／ml）为3.09±0.52，移植后14 d、28 d、6个月、1年外周血Log（sjTREC copies／ml）分别为1.18±0.22、2.16±0.31、1.31±0.20、1.83±0.31，1年后恢复到移植前水平，1.5年时为2.15±0.35，与健康对照组比较差异无统计学意义（P＞0.05）；移植后sjTREC的恢复与年龄无明显相关性；合并有急性移植物抗宿主病（aGVHD）患者，移植1年内外周血sjTREC含量较低，1.5年后与无aGVHD者无明显区别。结论 改良的sjTREC定量方法，适用于研究异基因造血干细胞移植后胸腺输出功能；异基因造血干细胞移植后胸腺功能恢复缓慢，aGVHD影响移植后早期胸腺功能的恢复。Objective To quantify sjTREC using a modified method in patients who underwent allogeneic hematopoietic stem transplantation （all-HSCT）, and determine the level of thymic output function and analyse the influencing factors in post-allo-HSCT patients. Methods Real time quantitative PCR was used to detect sjTREC levels from the peripheral blood DNA of pre-transplantation, 14 d, 28 d, 3 m, 6 m, 9 m, 1 y, 1.5 y, 2 y, 2.5 y, and above 2.5 y after HSCT, and analyse thymic output function and related factors after HSCT. sjTREC levels in 24 normal individuals were also determined to use as the normal range. Results The mean of Log （sjTREC copies/ml） in normal individuals was 3.74±0.26. Negative correlation existed between the Log sjTREC and the age （r = -0.65, P 〈 0.01）. There was no clear association between the TREC and the gender. Log sjTREC in pre-transplantation patients was 3.09±0.52, and the levels of sjTREC in 14 d, 28 d, 6 m, 1 y after HSCT were 1.18±0.22, 2.16±0.31, 1.31±0.2, 1.83±0.31, respectively. There was no significant difference between normal individuals and patients 1.5 years after HSCT. The post-transplantation level of sjTREC was not related to the age, but was negatively correlated to the acute graft versus host disease （aGVHD） 1 year after HSCT. There was no difference between patients with or without aGVHD 1.5 years post-HSCT. Conclusion The modified method for detecting sjTREC is applicable to allo-HSCT. The recovery of thymic output function after allo-HSCT is slow, in which aGVHD may have a negative effect.

关 键 词：造血干细胞移植 sjTREC 胸腺输出 聚合酶链反应 

分 类 号：R733[医药卫生—肿瘤]