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背景:通过促进调节性T细胞的产生及增强其功能的发挥已成为维持移植物免疫耐受的有效手段。目的:探讨他克莫司和西罗莫司对行肝移植的肝癌患者Foxp3+调节性T细胞产生及肝癌复发的影响。方法:纳入符合米兰标准的肝癌肝移植患者40例,随机分为西罗莫司组和他克莫司组,每组20例,移植后第2~12个月间每月抽取受试者外周血检测Foxp3+调节性T细胞,并行彩超和外周血检测甲胎蛋白,必要时肝穿刺活检观察排斥反应及肿瘤的复发情况。结果与结论:流式细胞仪检测结果显示,西罗莫司组外周血Foxp3+调节性T细胞阳性率明显高于他克莫司组(P<0.05),移植肝穿刺活检证实西罗莫司组排斥反应与他克莫司组差异无显著性意义(P>0.05),而移植肝彩超、外周血甲胎蛋白检测及移植肝穿刺活检或手术亦证实在肝癌复发率方面西罗莫司组明显低于他克莫司组(P<0.05)。说明西罗莫司在肝癌肝移植中对肿瘤复发的抑制作用方面优于他克莫司,且排斥反应较他克莫司并未增加,甚至有更好的免疫耐受效果。
BACKGROUND: It has become an effective means to maintain the immune tolerance of allografts by promoting the production of regulatory T cells and enhancing their functions. Objective: To investigate the effects of tacrolimus and sirolimus on the generation of Foxp3 + regulatory T cells and the recurrence of liver cancer in liver cancer patients undergoing liver transplantation. Methods: Forty patients with liver cancer who met the Milan criteria were randomly divided into two groups: 20 patients in each group and 2 patients in each group. Peripheral samples Blood test Foxp3 regulatory T cells, parallel ultrasound and peripheral blood of alpha-fetoprotein, if necessary, liver biopsy rejection and tumor recurrence observed. RESULTS AND CONCLUSION: The results of flow cytometry showed that the positive rate of Foxp3 + regulatory T cells in the peripheral blood of sirolimus group was significantly higher than that of the tacrolimus group (P <0.05). Liver biopsy confirmed the sirolimus group Rejection and tacrolimus group no significant difference (P> 0.05), and transplanted liver ultrasound, peripheral blood alpha-fetoprotein testing and transplanted liver biopsy or surgery also confirmed the recurrence rate of liver cancer in sirolimus group was significantly Lower than the tacrolimus group (P <0.05). This shows that sirolimus is better than tacrolimus in inhibiting the recurrence of liver cancer in liver cancer liver transplantation, and the rejection has no increase compared with tacrolimus, and even better immune tolerance effect.