肝移植术后发生急性排斥的患者外周血滤泡杀伤性T淋巴细胞的表达特点及临床意义  

Characteristics and clinical significance of peripheral follicular cytotoxic T cells in patients experiencing acute rejection after liver transplantation

作　　者：张可[1] 杨帆[1] 孙艳玲[2] 刘振文[2] 王福生[1] 施明[1] ZHANK Ke YANG Fan SUN Yanling et al(Treatment and Research Center for Infectious Diseases, 302 Military Hospital of China - Peking University Teaching Hospital, Belting 100039, China)

机构地区：[1]北京大学解放军三〇二医院教学医院感染性疾病诊疗与研究中心,北京100039 [2]北京大学解放军三〇二医院教学医院肝移植研究中心,北京100039

出　　处：《临床肝胆病杂志》2017年第7期1336-1339,共4页Journal of Clinical Hepatology

基　　金：国家自然科学基金(81571567)

摘　　要：目的研究肝移植患者外周血中滤泡杀伤性T淋巴细胞(Tfc)的表达特征及其在急性排斥反应中的意义。方法收集2015年12月-2017年2月解放军第三〇二医院肝移植研究中心接受肝移植患者36例,其中11例发生急性排斥反应(AR组),余下25例未发生排斥反应(NAR组),急性排斥反应均由病理诊断确诊。另选取体检中心健康者20例作为对照(HC组)。应用流式细胞仪检测外周血中Tfc的特点,并分析其与总B淋巴细胞、幼稚B淋巴细胞和类别转换记忆性B淋巴细胞和浆细胞以及肝功能指标之间的相关性。计量资料多组间比较采用Kruskal-Wallis H检验,进一步两两比较采用Mann-Whitney U检验,相关性分析采用Spearman秩相关。结果 3组之间患者外周血Tfc的频率差异有统计学意(H=32.18,P<0.001),AR组患者外周血中Tfc的频率明显高于NAR组(U=60,P=0.008)和HC组(U=2,P<0.001),NAR组Tfc的表达明显高于HC组(U=40,P<0.001)。Tfc频率与总B淋巴细胞、幼稚B淋巴细胞呈正相关(r值分别为0.665、0.462,P值均<0.001);与类别转换记忆性B淋巴细胞和浆细胞呈负相关(r=-0.453,P=0.001);与血清GGT水平呈正相关(r=0.371,P=0.026)。结论肝移植术后发生急性排斥反应的患者外周血中Tfc频率升高,且与B淋巴细胞以及肝脏胆管损伤存在一定的相关性,Tfc可能参与了肝移植术后的急性排斥反应。Objective To investigate the expression characteristics of peripheral follicular cytotoxic T（Tfc） cells in patients undergoing liver transplantation and their significance in acute rejection.Methods A total of 36 patients who underwent liver transplantation in Liver Transplantation Research Center in 302 Hospital of PLA from December 2015 to February 2017 were enrolled,and among these patients,11 experienced acute rejection（AR group） and 25 did not experience acute rejection（NAR group）.A confirmed diagnosis of acute rejection was made by pathological diagnosis.Another 20 healthy volunteers in Physical Examination Center were enrolled as controls（HC group）.Flow cytometry was used to investigate the characteristics of Tfc in peripheral blood and its correlation with total B lymphocytes,juvenile B lymphocytes,memory B lymphocytes,plasma cells,and liver function parameters.The Kruskal-Wallis H test was used for comparison of continuous data between multiple groups,and the Mann-Whitney U test was used for further comparison between any two groups;Spearman rank correlation was used for correlation analysis.Results The AR group had a significantly higher frequency of Tfc in peripheral blood than the NAR group（U=60,P=0.008） and the HC group（U=2,P〈0.001）,and the NAR group had a significantly higher frequency of Tfc than the HC group（U=40,P〈0.001）.The frequency of Tfc was positively correlated with total B lymphocytes and juvenile B lymphocytes（r=0.665 and 0.462,both P〈0.001）,negatively correlated with memory B lymphocytes and plasma cells（r=-0.453,P=0.001）,and positively correlated with serum gamma-glutamyl transpeptidase level（r=0.371,P=0.026）.Conclusion There is an increase in the frequency of peripheral Tfc in patients who experience acute rejection after liver transplantation,which is correlated with B lymphocytes and hepatic bile duct injury.Tfc may be involved in acute rejection after liver transplantation.

关 键 词：肝移植 移植物排斥 T淋巴细胞 

分 类 号：R657.3[医药卫生—外科学]