肺移植术后急性细胞介导排斥反应的诊疗新进展  

New progress on diagnosis and treatment of acute cellular rejection after lung transplantation

作　　者：徐钰 练巧燕 陈奥 张建恒[1] 徐鑫[1] 韦兵[1] 蔡宇航 黄丹霞[1] 邝敏婷 何建行[1] 巨春蓉[1] Xu Yu;Lian Qiaoyan;Chen Ao;Zhang Jianheng;Xu Xin;Wei Bing;Cai Yuhang;Huang Danxia;Kuang Minting;He Jianxing;Ju Chunrong(Guangzhou Institute of Respiratory Health,State Key Laboratory of Respiratory Disease,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510012,China)

机构地区：[1]广州医科大学附属第一医院广州呼吸健康研究院呼吸疾病国家重点实验室,510012

出　　处：《器官移植》2021年第5期614-618,共5页Organ Transplantation

基　　金：广东省钟南山医学基金会(ZNSA-2020013);广州呼吸健康研究所基金(2019GIRHZ04)。

摘　　要：急性细胞介导排斥反应(ACR)是肺移植术后常见的并发症,主要是由T淋巴细胞识别移植物细胞表面的主要组织相容性复合体引发的免疫反应,目前被认为是急性排斥反应的主要形式。ACR不仅可以直接导致受者死亡,也是肺移植术后慢性排斥反应的高危因素。但肺移植术后ACR的诊断困难,治疗棘手。本文总结了肺移植受者ACR的危险因素、发病机制、诊断和治疗新进展,以期提高ACR的诊治效率,延长受者生存期。Acute cellular rejection(ACR)is a common complication after lung transplantation,which is mainly caused by the immune response of T lymphocytes recognizing the major histocompatibility complex on the cellular surface of grafts.It is currently considered as the main pattern of acute rejection.ACR is not only a direct cause of death of recipients,but also a high-risk factor for chronic rejection after lung transplantation.Nevertheless,it is a challenging task to deliver the diagnosis and treatment of ACR following lung transplantation.In this article,new progresses on the risk factors,pathogenesis,diagnosis and treatment of ACR in lung transplant recipients were summarized,aiming to improve the diagnostic and treatment efficiency of ACR and prolong the survival of recipients.

关 键 词：肺移植 急性细胞介导排斥反应 细胞毒T淋巴细胞 人类白细胞抗原(HLA) 主要组织相容性复合体(MHC) 组织病理学检查 支气管肺泡灌洗液 血管内皮生长因子(VEGF) 

分 类 号：R617[医药卫生—外科学] R563[医药卫生—临床医学]