肾移植术后稳定状态受者淋巴细胞亚群的动态变化及其与肾功能的相关性分析

马锡慧; 韩永; 李彬钰; 孔祥瑞; 孙玉洁; 肖漓

doi:10.3969/j.issn.1674-7445.2020.05.005

肾移植术后稳定状态受者淋巴细胞亚群的动态变化及其与肾功能的相关性分析

Dynamic changes of lymphocyte subsets and their correlation with renal function in recipients with stable graft status after renal transplantation

摘要

摘要:
目的探讨肾移植术后稳定状态受者外周血淋巴细胞亚群的动态变化及其与肾功能的相关性。
方法筛选行首次肾移植且术后半年内移植肾功能稳定的受者45例, 采用流式细胞术(FCM)检测受者术后15 d及1、3、6个月共计180份外周血样本淋巴细胞亚群比例和绝对值。分析淋巴细胞亚群随术后时间延长的动态变化及其与血清肌酐(Scr)和血尿素氮(BUN)的相关性。
结果受者术后4个时间点Scr值比较, 差异均无统计学意义(均为P > 0.05)。术后15 d与术后1个月、术后1个月与术后3个月BUN比较, 差异均有统计学意义(P=0.002、P=0.001);术后15 d与术后1个月比较, CD3⁺CD8⁺T细胞、CD3⁺CD4⁺T细胞、自然杀伤(NK)细胞比例及CD4/CD8比值, 差异均有统计学意义(P=0.009、P=0.004、P < 0.001、P=0.004)。B细胞比例术后15 d与术后1个月比较、术后1个月与术后3个月比较, 差异均有统计学意义(均为P < 0.001)。CD3⁺T细胞、CD3⁺CD8⁺T细胞、CD3⁺CD4⁺T细胞和NK细胞绝对值术后15 d与术后1个月比较, 差异均有统计学意义(P=0.001、P=0.002、P=0.003、P < 0.001)。CD3⁺CD8⁺T细胞绝对值术后3个月和术后6个月比较, 差异有统计学意义(P=0.015)。B细胞绝对值术后1个月与术后3个月比较, 差异有统计学意义(P=0.001)。淋巴细胞亚群比例和绝对值与Scr均不相关(均为P > 0.05), CD3⁺CD8⁺T细胞、NK细胞比例和绝对值与BUN均呈负相关(P < 0.001~0.05), CD3⁺CD4⁺T细胞、B细胞比例与BUN均呈正相关(P < 0.001~0.05), CD3⁺T细胞绝对值与BUN呈负相关(P < 0.05)。
结论肾移植术后稳定状态受者的淋巴细胞亚群中T细胞和NK细胞术后1个月内升高至稳定状态, B细胞术后3个月内降低至稳定状态, 且淋巴细胞亚群的动态变化与BUN相关。

Abstract:
Objective To investigate the dynamic changes of peripheral blood lymphocyte subsets and their correlation with renal function in recipients with stable graft status after renal transplantation.
Methods Forty-five recipients who underwent renal transplantation for the first time and had stable graft function within postoperative 6 months were selected. The proportion and absolute value of lymphocyte subsets were detected by flow cytometry (FCM) in 180 peripheral blood samples from recipients at 15 d, 1, 3 and 6 months after renal transplantation. The dynamic changes of lymphocyte subsets with the extension of postoperative time and their correlation with serum creatinine (Scr) and blood urea nitrogen (BUN) were analyzed.
Results The Scr levels did not significantly differ at 4 time points after renal transplantation (all P > 0.05). The BUN levels significantly differed between 15 d and 1 month after renal transplantation, and between 1 and 3 months after renal transplantation (P=0.002, P=0.001). The proportion of CD3⁺CD8⁺T cells, CD3⁺CD4⁺T cells, natural killer (NK) cells and CD4/CD8 ratio at postoperative 15 d significantly differed from those at 1 month after operation (P=0.009, P=0.004, P < 0.001, P=0.004). The proportion of B cells significantly differed between 15 d and 1 month, and between 1 and 3 months after renal transplantation (both P < 0.001). The absolute values of CD3⁺T cells, CD3⁺CD8⁺T cells, CD3⁺CD4⁺T cells and NK cells at postoperative 15 d significantly differed from those at 1 month after renal transplantation (P=0.001, P=0.002, P=0.003, P < 0.001). The absolute values of CD3⁺CD8⁺T cells significantly differed between 3 and 6 months after operation (P=0.015). The absolute value of B cells at 1 month after renal transplantation significantly differed from that at 3 months after renal transplantation (P=0.001). The proportion and absolute value of lymphocyte subsets were not significantly correlated with the Scr level (both P > 0.05). The proportion and absolute value of CD3⁺CD8⁺T cells and NK cells were negatively correlated with BUN (P < 0.001-0.05), whereas the proportion of CD3⁺CD4⁺T cells and B cells was positively correlated with the BUN level (P < 0.001-0.05). The absolute value of CD3⁺T cells was negatively associated with the BUN level (P < 0.05).
Conclusions T cells and NK cells in the lymphocyte subsets of stable recipients raise to the stable state within 1 month after renal transplantation, whereas B cells decrease to stable state within 3 months renal transplantation. The dynamic changes of lymphocyte subsets are correlated with the BUN level.

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