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目的 观察CD38+CD8+T淋巴细胞水平在肾移植后巨细胞病毒感染患者体内的变化,探讨其监测肾移植后巨细胞病毒活动性感染的可能性。方法 分别应用流式细胞术和免疫组织化学方法测定56例肾移植受者手术前后的CD38+CD8+T淋巴细胞水平和巨细胞病毒白细胞抗原,并将两者结果进行比较。结果 肾移植术前所有患者巨细胞病毒白细胞抗原均为阴性,其(CD38+CD8+)/CD8+的平均比值为0.11±0.05;肾移植后检测到有14例患者巨细胞病毒白细胞抗原阳性,出现阳性的时间为术后(32.7±16.6)d,(CD38+CD8+)/CD8+的比值在术后(29.6±8.4)d出现了有显著意义的升高,平均数值为0.43±0.21。这些患者接受静脉滴注丙氧鸟苷治疗后巨细胞病毒白细胞抗原转阴,(CD38+CD8+)/CD8+平均比值下降为0.16±0.09。治疗前后CD38+CD8+T淋巴细胞水平比较差异有显著性意义(P<0.05)。结论 CD38+CD8+T淋巴细胞水平的检测结合巨细胞病毒白细胞抗原检查有助临床监测肾移植后CMV活动性感染。
Objective To observe the changes of CD38 + CD8 + T lymphocytes in patients with cytomegalovirus infection after renal transplantation, and to explore the possibility of monitoring the cytotoxic activity of cytomegalovirus after renal transplantation. Methods The levels of CD38 + CD8 + T lymphocytes and cytomegalovirus leukocyte antigens in 56 renal transplant recipients before and after operation were measured by flow cytometry and immunohistochemistry. The results of the two methods were compared. Results All patients with cytomegalovirus leukocyte antigens were negative before renal transplantation. The average ratio of (CD38 + CD8 +) / CD8 + was 0.11 ± 0.05. Fourteen patients were positive for cytomegalovirus leukocyte antigen (32.7 ± 16.6) days postoperatively. The ratio of (CD38 + CD8 +) / CD8 + increased significantly after operation (29.6 ± 8.4 days) with an average of 0.43 ± 0.21. These patients were treated with intravenous ganciclovir cytomegalovirus leukocyte antigen negative, (CD38 + CD8 +) / CD8 + average ratio decreased to 0.16 ± 0.09. The levels of CD38 + CD8 + T lymphocytes before and after treatment were significantly different (P <0.05). Conclusion The detection of CD38 + CD8 + T lymphocyte level combined with cytomegalovirus leukocyte antigen test will help to monitor CMV active infection after renal transplantation clinically.