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目的探讨肾移植术后外周血自然杀伤细胞(NK细胞)的CD158b表达及意义。方法测定62例患者肾移植前、术后第1d、术后第7d、肾功能正常时以及疑有排斥反应时外周血NK细胞的CD158b表达水平。结果62例中,术后38例肾功能恢复正常,观察期内无排斥反应发生,移植前后外周血CD3-CD16/CD56+细胞(NK细胞)及CD3-CD16/CD56+CD158b+细胞稳定,NK细胞中CD158b+细胞的比例也稳定;24例术后7～14d发生急性排斥反应,其外周血CD3-CD16/CD56+细胞呈上升趋势,CD3-CD16/CD56+CD158b+细胞呈下降趋势,NK细胞中CD158b+细胞的比例也呈下降趋势,经单因素方差分析,各指标在不同测定时点的差异均有统计学意义(P<0.05,P<0.01)。结论干扰NK细胞表达CD158b的因素较少,在临床上做出排斥反应诊断前,患者外周血中NK细胞的CD158b表达即呈下降趋势,因此术后监测NK细胞的CD158b表达可为评价患者的免疫状况提供依据。
Objective To investigate the expression of CD158b in peripheral blood natural killer (NK) cells after renal transplantation and its significance. Methods The expression levels of CD158b in peripheral blood NK cells before and after kidney transplantation, on the first day after operation, on the seventh day after the operation, in the normal kidney function and in the suspected rejection were measured in 62 patients. Results In the 62 cases, the renal function returned to normal after operation in 38 cases. No rejection occurred during the observation period. CD3-CD16 / CD56 + cells and CD3-CD16 / CD56 + CD158b + cells in peripheral blood were stable before and after transplantation. The percentage of CD158b + cells was also stable. The acute rejection occurred in 24 patients 7 ~ 14 days after operation. The numbers of CD3-CD16 / CD56 + cells in the peripheral blood of the 24 patients showed an upward trend. The CD3-CD16 / CD56 + CD158b + The proportion also showed a downward trend. By the single factor analysis of variance, the differences of each index at different time points were statistically significant (P <0.05, P <0.01). Conclusions The factors that interfere with the expression of CD158b in NK cells are less. Before the diagnosis of rejection, the expression of CD158b in NK cells in peripheral blood of patients is decreasing. Therefore, monitoring the expression of CD158b in NK cells can evaluate the immune response Status provided basis.