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目的探讨肾移植患者CD3+CD16+CD56+自然杀伤T细胞(NKT)在外周血中的表达与移植肾免疫状态的关系,以及钙调磷酸酶抑制剂(CNI)不同的血药浓度下NKT细胞的水平。方法将92例肾移植患者根据CNI血药浓度水平及有无排斥反应分为3组:正常血药浓度的无排斥组(A组,58例)、低血药浓度的无排斥组(B组,8例)、排斥组(C组,26例),10例正常人群作为对照组(D组),采用流式细胞术检测各组外周血CD3+、CD3+CD4+、CD3+CD8+、CD3-CD16+CD56+自然杀伤(NK)和CD3+CD16+CD56+NKT细胞及人白细胞抗原(HLA)抗体的水平。结果 A、B、C、D组CD3+CD16+CD56+NKT细胞的百分数分别是(4.29±2.57)%、(4.31±2.08)%、(1.23±1.06)%、(3.98±2.26)%。A、B组与D组比较,NKT细胞百分数、NK细胞百分数及CD4+/CD8+无差异,HLA抗体阳性比率无显著升高;C组NKT细胞的百分数与正常对照组相比降低(P<0.05),NK细胞、CD4+/CD8+均显著高于D组(P<0.05),HLA抗体阳性比率显著升高。结论肾移植后排斥反应时NKT细胞低表达,出现HLA抗体;无排斥反应时NKT细胞表达正常,不受低血药浓度的影响。CD3+CD16+CD56+NKT细胞在抑制移植肾免疫激活中起着重要作用。
Objective To investigate the relationship between the expression of CD3 + CD16 + CD56 + natural killer T cells (NKT) in peripheral blood and the immune status of renal allografts in renal allograft recipients, and to investigate the relationship between NKT cells and NKT cells in different concentrations of calcineurin inhibitor (CNI) Level. Methods Ninety-two renal transplant recipients were divided into three groups based on the blood concentration of CNI and whether there was rejection or not: normal group (group A, 58 cases), low group , 8 cases), rejection group (C group, 26 cases) and 10 normal people as control group (D group). The levels of CD3 +, CD3 + CD4 +, CD3 + CD8 +, CD3- + CD56 + natural killer (NK) and CD3 + CD16 + CD56 + NKT cells and human leukocyte antigen (HLA) antibodies. Results The percentages of CD3 + CD16 + CD56 + NKT cells in groups A, B, C and D were (4.29 ± 2.57)%, (4.31 ± 2.08)%, (1.23 ± 1.06)% and (3.98 ± 2.26)%, respectively. The percentage of NKT cells, percentage of NK cells and CD4 + / CD8 + in group A and group B were not significantly different from those in group D. The percentage of NKT cells in group C was lower than that in control group (P <0.05) , NK cells and CD4 + / CD8 + were significantly higher than those in group D (P <0.05). The positive rate of HLA antibodies was significantly increased. Conclusions NKT cells are low expressed after rejection, and have HLA antibodies. NKT cells are normal without rejection and are not affected by low serum concentration. CD3 + CD16 + CD56 + NKT cells play an important role in inhibiting immune activation of renal allografts.