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他克莫司对不同生存期肝移植患者肝脏和细胞免疫功能的影响
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| 篇名： | 他克莫司对不同生存期肝移植患者肝脏和细胞免疫功能的影响 |
| TITLE： | |
| 摘要： | 目的：探讨他克莫司（FK506）对不同生存期肝移植患者外周血细胞免疫功能及肝脏实验室指标的影响。方法：选取采用FK506治疗的肝移植患者27例，1年≤生存期＜5年为A组（16例），5年≤生存期≤12年为B组（11例），同时选取10例健康志愿者作为对照组。A、B组患者均给予FK506 0.1～0.2 mg/kg，bid；对照组健康志愿者不采取任何治疗。比较两组患者及健康志愿者外周血中T淋巴细胞CD3+、CD3+CD4+、CD3+CD8+、CD4+/CD8+及B细胞CD19+、自然杀伤细胞CD16+CD56+水平，并考察两组患者及健康志愿者血清中丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、白蛋白（ALB）、γ-谷氨酰转肽酶（GGT）的水平。结果： B组患者CD3+CD4+、CD19+、CD4+/CD8+明显低于A组及对照组，CD3+CD8+明显高于A组及对照组，差异有统计学意义（P＜0.005）；B组患者CD3+、CD16+CD56+与A组及对照组比较，差异无统计学意义（P＞0.05）；A组患者上述指标与对照组比较，差异无统计学意义（P＞0.05）。A、B组患者GGT水平均高于对照组，A组患者AST水平明显高于对照组，B组患者ALB水平明显低于对照组，差异均有统计学意义（P＜0.05）；A、B组患者ALT水平与对照组比较，差异无统计学意义（P＞0.05）；A、B组患者ALT、AST、ALB、GGT水平比较，差异亦无统计学意义（P＞0.05）。结论：FK506对生存期5～12年的肝移植患者易产生过度免疫抑制，术后可通过监测外周血CD3+CD4+、CD3+CD8+、CD4+/CD8+值评估肝移植患者的免疫状态，及时调整FK506剂量，避免产生过度免疫抑制。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects of tacrolimus （FK506） on peripheral blood cell immune function and liver lab index in liver transplant recipients different survival periods. METHODS： 27 liver transplant recipients receiving FK506 were selected and divided into group A （1 year≤ survival period＜5 years， 16 cases） and group B （5 years≤survival period≤12 years， 11 cases）. At the same time， 10 healthy volunteers were included into control group. Group A and B were given FK506 0.1-0.2 mg/kg， bid； control group didn’t received any treatment. Peripheral blood T leukomonocyte CD3+， CD3+CD4+， CD3+CD8+and CD4+/CD8+， B cell CD19+ and NK cell CD16+CD56+ level were compared among 3 groups. The levels of ALT， AST， ALB and GGT were investigated in 3 groups. RESULTS： The percentage of CD3+CD4+， CD19+ and CD4+/CD8+ ratio in group B were significantly lower than in group A and control group， and CD3+CD8+ was significantly higher than in group A and control group， with statistical significance （P＜0.005）； there was no statistical significance in CD3+， CD16+CD56+ in group B， compared to group A and control group （P＞0.05）. There was no statistical significance in above index between group A and control group （P＞0.05）. The level of GGT in the group A and group B was higher than that in the control group. AST of group A was significantly higher than that of control group， and ALB of group B was significantly lower than control group， with statistical significance （P＜0.05）； there was no statistical significance in ALT， of group A and B， compared to control group （P＞0.05）； there was no statistical significance in the levels of ALT， AST， ALB and GGT between group A and group B （P＞0.05）. CONCLUSIONS： Immune function of liver transplant recipients with 5-12 years survival time was easily suppressed by FK506. CD3+CD4+， CD3+CD8+， CD4+/CD8+ level may serve as biomarkers to reflect the immune status of recipients and help to adjust the dose of FK506 timely and avoid the excessive immunosuppression. |
| 期刊： | 2016年第27卷第14期 |
| 作者： | 张咏赞，张翠欣，窦剑，赵萌 |
| AUTHORS： | ZHANG Yongzan，ZHANG Cuixin，DOU Jian，ZHAO Meng |
| 关键字： | 他克莫司；肝移植；T淋巴细胞；免疫耐受；过度免疫抑制 |
| KEYWORDS： | Tacrolimus；Liver transplantation recipients；T lymphocyte；Immune tolerance； Excessive immunosuppression |
| 阅读数： | 304 次 |
| 本月下载数： | 3 次 |
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