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外周血淋巴细胞亚群绝对值和功能的动态监测在肾移植术后早期病毒感染风险预测中的价值

张倩倩 谢亚龙 汪峰 罗颖 陈松 张伟杰 昌盛

张倩倩, 谢亚龙, 汪峰, 等. 外周血淋巴细胞亚群绝对值和功能的动态监测在肾移植术后早期病毒感染风险预测中的价值[J]. 器官移植, 2022, 13(1): 80-87. doi: 10.3969/j.issn.1674-7445.2022.01.013
引用本文: 张倩倩, 谢亚龙, 汪峰, 等. 外周血淋巴细胞亚群绝对值和功能的动态监测在肾移植术后早期病毒感染风险预测中的价值[J]. 器官移植, 2022, 13(1): 80-87. doi: 10.3969/j.issn.1674-7445.2022.01.013
Zhang Qianqian, Xie Yalong, Wang Feng, et al. Value of dynamic monitoring of absolute value and function of peripheral blood lymphocyte subsets in predicting the risk of early viral infection after kidney transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(1): 80-87. doi: 10.3969/j.issn.1674-7445.2022.01.013
Citation: Zhang Qianqian, Xie Yalong, Wang Feng, et al. Value of dynamic monitoring of absolute value and function of peripheral blood lymphocyte subsets in predicting the risk of early viral infection after kidney transplantation[J]. ORGAN TRANSPLANTATION, 2022, 13(1): 80-87. doi: 10.3969/j.issn.1674-7445.2022.01.013

外周血淋巴细胞亚群绝对值和功能的动态监测在肾移植术后早期病毒感染风险预测中的价值

doi: 10.3969/j.issn.1674-7445.2022.01.013
基金项目: 

国家自然科学基金面上项目 81873511

中国器官移植发展基金会“移植领创计划” YZLC-2021-005

湖北省卫生计生科研项目 WJ2019Z007

详细信息
    作者简介:

    张倩倩,女,1994年生,硕士,住院医师,研究方向为器官移植与免疫,Email:QianqianAhaha@163.com

    通讯作者:

    昌盛,男,1973年生,博士,主任医师,研究方向为器官移植与免疫,Email:changsheng@hust.edu.cn

  • 中图分类号: R617, R619+.3

Value of dynamic monitoring of absolute value and function of peripheral blood lymphocyte subsets in predicting the risk of early viral infection after kidney transplantation

More Information
  • 摘要:   目的  探讨不同淋巴细胞亚群的绝对值和功能对于评估肾移植受者术后早期发生病毒感染风险的预测和诊断价值。  方法  将95例肾移植受者纳入前瞻性观察队列研究,根据术后的免疫状态分为稳定组(77例)和感染组(18例)。分别于术前、术后2周、术后1个月、术后2个月、术后6个月采集外周血样本进行流式细胞检测。比较两组CD4+T细胞、CD8+T细胞、自然杀伤(NK)细胞绝对值的动态变化,通过检测干扰素(IFN)-γ+CD4+T细胞、IFN-γ+CD8+T细胞、IFN-γ+NK细胞比例分析两组受者淋巴细胞亚群功能,评估淋巴细胞亚群绝对值和功能在肾移植术后早期对病毒感染的预测和诊断价值。  结果  在病毒感染时,感染组的CD4+T细胞、CD8+T细胞、NK细胞绝对值整体处于相对较低的水平;在术后2个月时,感染组的CD4+T细胞、NK细胞绝对值均低于稳定组;在术后6个月时,感染组的CD4+T细胞、CD8+T细胞绝对值均低于稳定组(均为P < 0.05)。在病毒感染时,感染组的IFN-γ+CD4+T细胞、IFN-γ+CD8+T细胞、IFN-γ+NK细胞比例均处于相对较低的水平,尤以IFN-γ+CD8+T细胞比例降低最为显著;在术后2个月,感染组的IFN-γ+CD8+T细胞、IFN-γ+NK细胞比例显著高于稳定组;在术后6个月,感染组的IFN-γ+CD4+T细胞、IFN-γ+CD8+T细胞比例均高于稳定组(均为P < 0.05)。logistic回归分析结果显示,术后2个月时,IFN-γ+CD8+T细胞和IFN-γ+NK细胞比例的升高与病毒感染风险增加均相关(均为P < 0.05)。受试者工作特征(ROC)曲线结果表明,淋巴细胞亚群绝对值联合其IFN-γ分泌功能对于免疫状态低下的受者病毒感染的诊断价值显著高于单用淋巴细胞亚群绝对值(P < 0.05)。  结论  动态监测淋巴细胞亚群绝对值和功能的变化对病毒感染的预测、诊断及指导用药具有重要参考价值。

     

  • 图  1  稳定组和感染组肾移植受者淋巴细胞亚群绝对值的比较

    注:图中数据以中位数表示。与术前比较,aP < 0.05/10;与术后2周比较,bP < 0.05/10;与术后1个月比较,cP < 0.05/10;与术后2个月比较,dP < 0.05/10;与感染时比较,eP < 0.05/10;与稳定组比较,*P < 0.05。

    Figure  1.  Comparison of absolute values of lymphocyte subsets in kidney transplant recipients of stable and infected groups

    图  2  稳定组和感染组肾移植受者淋巴细胞亚群功能的比较

    注:图中数据以中位数表示。与术前比较,aP < 0.05/10;与术后2周比较,bP < 0.05/10;与术后1个月比较,cP < 0.05/10;与术后2个月比较,dP < 0.05/10;与感染时比较,eP < 0.05/10;与稳定组比较,*P < 0.05。

    Figure  2.  Comparison of function of lymphocyte subsets in kidney transplant recipients of stable and infected groups

    图  3  淋巴细胞亚群绝对值和功能预测病毒感染的logistic回归分析

    Figure  3.  Logistic regression analysis of absolute values and function of lymphocyte subsets to predict viral infection

    图  4  淋巴细胞亚群绝对值和功能诊断肾移植受者病毒感染的ROC曲线

    注:A图示单个不同指标诊断肾移植受者病毒感染的ROC曲线;B图示淋巴细胞亚群绝对值或功能诊断肾移植受者病毒感染的ROC曲线;C图示淋巴细胞亚群绝对值联合其功能诊断肾移植受者病毒感染的ROC曲线。

    Figure  4.  ROC curves of absolute values and function of lymphocyte subsets in diagnosing viral infection in kidney transplant recipients

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出版历程
  • 收稿日期:  2021-09-25
  • 网络出版日期:  2022-01-12
  • 刊出日期:  2022-01-15

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