丙型肝炎病毒感染对肾移植患者免疫功能的影响  

Influence of HCV infection on immune state in the patients with kidney transplantation

作　　者：严春寅[1] 王晖 陈卫国[1] 张炜[3] 郭震华[1] 陈赐龄[1] 

机构地区：[1]苏州医学院附属第一医院泌尿外科,215006 [2]日本国金汜尺大学 [3]苏州医学院附属第一医院泌尿外科实验室,215006

出　　处：《中华器官移植杂志》2000年第5期296-297,共2页Chinese Journal of Organ Transplantation

摘　　要：目的　探讨丙型肝炎病毒 (HCV)感染对肾移植患者免疫功能的影响。方法　提取患者外周血的淋巴细胞 ,应用碱性磷酸酶 抗碱性磷酸酶 (APAAP)酶桥联法检测CD3+、CD4+、CD8+及CD16 +细胞 ;免疫沉淀法测定血清中免疫球蛋白和补体水平。结果　HCV IgG和 /或HCVRNA阳性者 (HCV阳性组 )CD4+/CD8+值为 0 .90± 0 .2 5 ,显著低于HCV阴性组的 1.46± 0 .5 4(P <0 .0 5 ) ,主要是CD4+细胞下降显著 ;HCV阳性组CD16 +细胞高达 2 7.8% ,与HCV阴性组比较 ,差异有显著性 (P <0 .0 1)。HCV阳性组和阴性组的血清各免疫球蛋白和补体的差异无显著性 (P >0 .0 5 )。结论　HCV阳性的肾移植患者其免疫功能紊乱。Objectives To investigate the changes in CD4 +/CD8 +, NK cells, immunogrobulins and complements in the peripheral blood in the hepatitis C virus (HCV) positive patients undergoing kidney transplantation and their influence on the immune state. Methods APAAP test was used to determine the levels of CD3 +, CD4 +, CD8 + cells and natural killing (NK) cells in peripheral blood in the kidney graft recipients; meanwhile, serum immunoglobulins and complements were measured by immunoprecipitation method. Results The mean ratio of CD4 +/CD8 + was 0.90±0.25 in the HCV positive group, significantly lower than 1.46±0.54 in the HCV negative group ( P < 0.05 ), accompanying with evident drop of the overall counts of CD4 + T cells but no remarkable changes in CD8 + T cells. The rate of CD16 + cells (NK) accounted for 27.8 *!% in the HCV positive group, higher than in the negative one ( P < 0.01 ). There were no significant changes in serum immunoglobulins and complements between the two groups ( P > 0.05 ). Conclusions The immune state in the HCV positive patients with kidney transplantation was too low to eliminate HCV efficiently. Determination of the CD4 +/CD8 + and the rate of NK cells was helpful to the clinical treatment of the HCV positive recipients.

关 键 词：肾移植 免疫功能 丙型肝炎病毒感染 

分 类 号：R699[医药卫生—泌尿科学]