论文部分内容阅读
背景:寻找肝移植急性排斥反应的早期诊断指标,可快速而有效的评估移植后排斥反应的风险,而T淋巴细胞在急性排斥反应中发挥主要作用。目的:观察恒河猴肝移植后血液T淋巴细胞亚群的变化与急性排斥反应的关系。方法:采用改良血管袖套+胆道支撑管+动脉吻合法建立16例稳定的恒河猴肝移植模型,并将模型随机分为2组:实验组围手术期不给予免疫抑制治疗,对照组围手术期给予免疫抑制治疗,分别在移植后6,12,24,72 h共4个时间点收集血标本和肝组织,全自动生化分析仪测定丙氨酸氨基转移酶、天冬氨酸氨基转移酶、总胆红素,用流式细胞仪检测血CD4+/CD8+水平,然后取移植后肝脏组织进行苏木精-伊红染色以观察肝脏组织形态结构的改变,并根据Banff评分系统判断排斥反应程度。结果与结论:实验组恒河猴肝移植后12,24,72 h均有急性排斥反应发生,其中实验组丙氨酸氨基转移酶、天冬氨酸氨基转移酶和总胆红素在移植后24,72 h表达水平明显高于对照组(P<0.05),实验组和对照组CD4+/CD8+的表达在移植后6 h即开始增高,实验组增高最明显,实验组移植后24,72 h CD4+/CD8+的表达明显高于对照组(P<0.05),实验组移植后72 h肝脏组织形态病理改变程度重于对照组,Banff评分高于对照组(P<0.05)。说明在肝移植后急性排斥反应早期,CD4+/CD8+的表达变化早于肝组织病理学及肝功能的改变。肝移植后血CD4+/CD8+水平的升高提示人体细胞免疫功能增强,对肝移植后急性排斥反应的早期诊断具重要意义。
Background: Looking for early diagnosis of acute rejection of liver transplantation can quickly and effectively assess the risk of rejection after transplantation, T lymphocytes play a major role in acute rejection. Objective: To observe the relationship between changes of blood T lymphocyte subsets and acute rejection after liver transplantation in Rhesus monkey. Methods: Sixteen stable rhesus monkey liver transplantation models were established by modified cuff, biliary support tube and arterial anastomosis. The models were randomly divided into two groups: the experimental group was given no perioperative immunosuppressive therapy, while the control group Immunosuppressive therapy was given during operation. Blood samples and liver tissues were collected at 4, 6, 12, 24, and 72 hours after transplantation respectively. Alanine aminotransferase, aspartate aminotransferase The level of CD4 + / CD8 + was measured by flow cytometry. The liver tissues were harvested for hematoxylin-eosin staining to observe the morphological changes of liver tissues. The rejection was determined according to the Banff score system degree. RESULTS AND CONCLUSION: In the experimental group, acute rejection occurred at 12, 24, and 72 hours after liver transplantation. The levels of alanine aminotransferase, aspartate aminotransferase and total bilirubin in experimental group after transplantation The expression of CD4 + / CD8 + in experimental group and control group began to increase at 6 h after transplantation, with the most obvious increase in experimental group at 24 and 72 h (P <0.05). At 24 h and 72 h after transplantation The expression of CD4 + / CD8 + in the experimental group was significantly higher than that in the control group (P <0.05). The degree of pathological changes of liver tissue in the experimental group at 72 h after transplantation was higher than that in the control group, and the Banff score was higher than that in the control group (P <0.05). The results showed that the expression of CD4 + / CD8 + changed earlier than that of the liver histopathology and liver function in the early stage of acute rejection after liver transplantation. The increase of blood CD4 + / CD8 + level after liver transplantation suggests that human cellular immune function is enhanced, which is of great significance for the early diagnosis of acute rejection after liver transplantation.