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流式细胞术在肾移植术后感染中的诊断价值

马锡慧 高钰 韩永 孙玉洁 杜若 刘培霞 张文慧 肖漓

马锡慧, 高钰, 韩永, 等. 流式细胞术在肾移植术后感染中的诊断价值[J]. 器官移植, 2018, 9(2): 137-141,155. doi: 10.3969/j.issn.1674-7445.2018.02.008
引用本文: 马锡慧, 高钰, 韩永, 等. 流式细胞术在肾移植术后感染中的诊断价值[J]. 器官移植, 2018, 9(2): 137-141,155. doi: 10.3969/j.issn.1674-7445.2018.02.008
Ma Xihui, Gao Yu, Han Yong, et al. Diagnostic value of flow cytometry in postoperative infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(2): 137-141,155. doi: 10.3969/j.issn.1674-7445.2018.02.008
Citation: Ma Xihui, Gao Yu, Han Yong, et al. Diagnostic value of flow cytometry in postoperative infection after renal transplantation[J]. ORGAN TRANSPLANTATION, 2018, 9(2): 137-141,155. doi: 10.3969/j.issn.1674-7445.2018.02.008

流式细胞术在肾移植术后感染中的诊断价值

doi: 10.3969/j.issn.1674-7445.2018.02.008
基金项目: 

国家自然科学基金 81571555

解放军第309医院面上课题 2016MS-002

详细信息
    作者简介:

    马锡慧,女,1985年生,硕士,主管技师,研究方向为移植免疫,Email: maxihui@sina.com

    通讯作者:

    肖漓,女,1972年生,博士,主任技师,研究方向为移植免疫,Email: xiaolilab309@163.com

  • 中图分类号: R617, R392.4

Diagnostic value of flow cytometry in postoperative infection after renal transplantation

More Information
  • 摘要:   目的  探讨流式细胞术在肾移植术后感染中的诊断价值。  方法  根据术后影像学和实验室检查结果,将51例首次肾移植受体分为细菌组33例、真菌组9例、BK病毒组9例;另选择肾移植术后稳定的受体28例作为稳定组。采用流式细胞术分析各组受体外周血淋巴细胞亚群比例和绝对计数。比较各组肾移植受体的肾功能、外周血淋巴细胞亚群的比例及绝对计数;采用受试者工作特征(ROC)曲线分析淋巴细胞亚群比例和绝对计数在肾移植术后感染性疾病中的诊断价值。  结果  与稳定组相比,细菌组、真菌组和BK病毒组血清肌酐(Scr)水平和血尿素氮(BUN)水平均有不同程度升高,差异均有统计学意义(P=0.035、0.007、0.024;0.037、0.006、0.032)。与稳定组比较,细菌组和真菌组CD16+CD56+自然杀伤(NK)细胞比例均下降(P=0.036、0.015);真菌组CD4+/CD8+T细胞比例明显下降(P=0.004)。与细菌组相比,真菌组和BK病毒组的CD3+CD8+T细胞比例均升高(P=0.013、0.008),CD3+CD4+T细胞比例均降低(P=0.003、0.010),CD4+/CD8+T细胞比例均明显下降(P=0.003、0.005)。与稳定组比较,细菌组、真菌组、BK病毒组CD3+T细胞数量、CD3+CD8+T细胞数量、CD16+CD56+NK细胞数量均明显降低(P=0.025、0.002、0.003;0.015、0.005、0.006;0.001、0.001、0.031);真菌组和BK病毒组CD3+CD4+T细胞数量降低(P=0.001、0.003);BK病毒组CD19+B细胞数量明显降低(P=0.019)。与细菌组比较,真菌组CD3+CD4+T细胞数量明显降低(P=0.023)。ROC曲线分析显示,CD3+CD4+T细胞和CD16+CD56+NK细胞数量诊断真菌感染的准确度较高,ROC曲线下面积分别为0.8492和0.8889;CD3+T细胞、CD3+CD4+T细胞和CD19+B细胞数量诊断BK病毒感染的准确度较高,ROC曲线下面积分别为0.8472、0.8452和0.8115。  结论  采用流式细胞术检测外周血淋巴细胞亚群可以评估患者机体免疫功能状态,绝对计数能够直观地判断免疫程度,两者结合对于肾移植受者感染性疾病的诊断和鉴别诊断具有指导意义。

     

  • 图  1  各组肾移植受体外周血淋巴细胞亚群比例的比较

    与稳定组比较,aP<0.05;与细菌组比较,bP<0.05

    Figure  1.  Comparison of the proportions of lymphocyte subsets in peripheral blood of renal transplant recipients among each group

    图  2  各组肾移植受体外周血淋巴细胞亚群绝对计数的比较

    与稳定组比较,aP<0.05;与细菌组比较,bP<0.05

    Figure  2.  Comparison of the absolute counts of lymphocyte subsets in peripheral blood of renal transplant recipients among each group

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出版历程
  • 收稿日期:  2017-12-10
  • 网络出版日期:  2021-01-19
  • 刊出日期:  2018-03-15

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