肺移植术后稳定状态受者T淋巴细胞亚群的动态变化分析

练巧燕; 陈奥; 徐鑫; 韦兵; 蔡宇航; 黄丹霞; 何建行; 巨春蓉

doi:10.3969/j.issn.1674-7445.2021.01.013

肺移植术后稳定状态受者T淋巴细胞亚群的动态变化分析

Analysis on dynamic changes of T lymphocyte subsets in recipients with stable graft status after lung transplantation

摘要

摘要:
目的分析肺移植术后稳定状态受者1年内T淋巴细胞亚群的动态变化及影响因素。
方法收集行同种异体肺移植手术且术后处于稳定状态的41例受者的临床资料。采用流式细胞术检测受者术前、术后2周及每个月（术后1年内）外周血T淋巴细胞亚群绝对值和比值。分析受者年龄、性别、体质量指数（BMI）、手术方式、原发性移植物功能障碍（PGD）发生情况及原发病对T淋巴细胞绝对值的影响。
结果肺移植术后1年内，CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值及CD4⁺/CD8⁺比值随时间变化差异有统计学意义（均为P < 0.001）。与术前相比，术后12个月CD3⁺、CD3⁺CD4⁺T淋巴细胞绝对值差异均无统计学意义（P=0.659、0.109），CD3⁺CD8⁺T淋巴细胞绝对值升高（P=0.02），而CD4⁺/CD8⁺比值下降，差异有统计学意义（P < 0.001）。肺移植受者的年龄、性别、BMI、手术方式以及术后是否出现PGD对CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值的动态变化无影响（P > 0.05）。肺移植术前原发病对CD3⁺CD4⁺T淋巴细胞的变化无影响，但感染性肺疾病受者术后CD3⁺CD8⁺T淋巴细胞绝对值较高（P < 0.05）。
结论肺移植术后稳定状态受者CD3⁺、CD3⁺CD4⁺、CD3⁺CD8⁺T淋巴细胞绝对值在术后早期较低，随后逐渐恢复，术后6个月后达到稳态。其动态变化与受者年龄、性别、BMI、手术方式以及术后是否出现PGD无关。

Abstract:
Objective To analyze the dynamic changes and the influencing factors of T lymphocyte subsets in recipients with stable graft status within 1 year after lung transplantation.
Methods Clinical data of 41 recipients with stable graft status after allogeneic lung transplantation were analyzed. The absolute value and ratio of T lymphocyte subsets in peripheral blood from recipients were measured by flow cytometry before operation, 2 weeks and each month (within 1 year) after operation, respectively. The effects of age, gender, body mass index (BMI), surgical method, incidence of primary graft dysfunction (PGD) after operation, and primary disease upon the absolute values of T lymphocytes were evaluated.
Results Within 1 year after lung transplantation, the absolute values of CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺T lymphocytes and CD4⁺/CD8⁺ ratio were changed over time (all P < 0.001). Compared with preoperative values, there was no statistical significance in the absolute values of CD3⁺ and CD3⁺CD4⁺T lymphocytes at 12 months after operation (P=0.659, 0.109), whereas the absolute value of CD3⁺CD8⁺T lymphocytes was increased (P=0.02) and the CD4⁺/CD8⁺ ratio was decreased (P < 0.001). Age, gender, BMI, surgical method and incidence of PGD after operation exerted no significant effect on the dynamic changes of absolute values of CD3⁺CD4⁺ and CD3⁺CD8⁺T lymphocytes (all P > 0.05). Primary disease before lung transplantation exerted no effect on the changes of CD3⁺CD4⁺T lymphocytes, whereas the postoperative absolute value of CD3⁺CD8⁺T lymphocytes was higher in recipients with infectious lung diseases (P < 0.05).
Conclusions The absolute values of CD3⁺, CD3⁺CD4⁺, CD3⁺CD8⁺T lymphocytes in recipients with stable graft status after lung transplantation are relatively low in the early stage after lung transplantation, then gradually restore, and stabilize at 6 months after operation. Dynamic changes are not associated with age, gender, BMI, surgical method and incidence of PGD after operation of recipients.

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