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目的探讨Immu Know检测免疫细胞功能在监测肾移植术后患者免疫功能变化的应用价值。方法 2013年1月至2014年12月在广州医科大学附属第二医院器官移植科实施肾移植手术的106例尿毒症患者,分别于术前、术后12个月内发生感染或急性排斥反应时抽取血液标本。采用Immu Know测定CD4+T细胞内的三磷腺苷(ATP)含量。观察与比较不同临床状态肾移植患者的ATP含量,包括术前组、稳定组、急性排斥反应组和感染组(含重症肺炎)。检测外周血T细胞亚群CD4+T细胞、CD8+T细胞及自然杀伤(NK)细胞比例。采用Pearson相关分析法了解ATP值与他克莫司(FK506)和环孢素(Cs A)血药谷浓度的关系。结果感染组患者ATP含量低于术后稳定组患者(P<0.001),其中发生重症肺炎患者ATP含量低于发生其他感染的患者(P<0.05)。感染组患者的CD4+T细胞百分比低于稳定组患者(P<0.05)。ATP含量与移植患者术后FK506和Cs A血药谷浓度无相关性。结论 Immu Know检测可用于监测肾移植患者术后免疫功能状态。CD4+T细胞内ATP含量检测对术后感染,特别是对重症肺炎有提示和预警作用。
Objective To explore the value of Immu Know immunocyte function in monitoring immune function in patients after renal transplantation. Methods From January 2013 to December 2014, 106 patients with uremia who underwent renal transplantation undergoing organ transplantation at the Second Affiliated Hospital of Guangzhou Medical University were infected or acute rejection within 12 months before and 12 months after operation. Blood samples were taken. Immu Know was used to determine the level of ATP in CD4 + T cells. Observe and compare the ATP content of renal transplant patients with different clinical status, including preoperative group, stable group, acute rejection group and infection group (including severe pneumonia). The proportion of CD4 + T cells, CD8 + T cells and natural killer (NK) cells in T lymphocyte subsets of peripheral blood were detected. Pearson correlation analysis was used to understand the relationship between ATP values and trough concentrations of tacrolimus (FK506) and cyclosporine (CsA). Results The ATP content in infected patients was lower than that in stable patients (P <0.001). The ATP content in patients with severe pneumonia was lower than that in patients with other infections (P <0.05). The percentage of CD4 + T cells in infected patients was lower than that in stable patients (P <0.05). There was no correlation between the content of ATP and the concentration of FK506 and CsA in transplanted patients. Conclusion Immu Know test can be used to monitor postoperative immune function in renal transplant recipients. Detection of ATP content in CD4 + T cells may have a warning and warning effect on postoperative infection, especially for severe pneumonia.