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目的 :探讨混合淋巴细胞培养 (MLC)上清液中细胞因子水平与肾移植术后急性排斥反应的关系 ,评价肾移植术前检测MLC上清液中细胞因子水平 ,作为预测急性排斥反应指标的临床价值。 方法 : 选取 48例接受同种异体肾移植术的患者为检测对象。在手术当日 ,分离其外周血单个核细胞 (PBMC)与供者单个核细胞进行混合培养 (反应组 ) ,同时以受者单纯自身PBMC进行培养 (对照组 )。在培养第 1、3、5天测MLC上清中IL 2和TNF α水平 ,并观察其分泌动态变化。 结果 : 发生急性排斥反应的患者 ,在 3次时间点上 ,两种细胞因子水平均高于肾功能稳定组 ,差异显著。在发生急性排斥反应和肾功能稳定的两组受者中 ,反应组较对照组细胞因子水平都有增加 ;急排的患者增加量高于肾功稳定的受者 ,差异显著。排斥组与肾功能稳定组两种细胞因子的分泌规律基本一致 ,但排斥组峰值都高于肾功能稳定组。 结论 :检测MLC上清液中细胞因子水平可以作为合理选择供受者、预测急性排斥反应的方法。
OBJECTIVE: To investigate the relationship between cytokine levels in supernatants of mixed lymphocyte (MLC) and acute rejection after renal transplantation and to evaluate cytokines levels in MLC supernatants before renal transplantation as an indicator of acute rejection Clinical Value. Methods: Forty-eight patients undergoing allogeneic kidney transplantation were selected as test subjects. On the day of surgery, peripheral blood mononuclear cells (PBMCs) were isolated and mixed with donor mononuclear cells (reaction group), while recipients were cultured in their own PBMCs alone (control group). The levels of IL-2 and TNF-α in the supernatants of MLC were measured on the 1st, 3rd and 5th day after culture, and their secretion dynamic changes were observed. Results: In the patients with acute rejection, the levels of the two cytokines were higher than those in the stable renal function group at three time points, the difference was significant. In the two groups of recipients with acute rejection and stable renal function, the levels of cytokines in the response group increased compared with those in the control group. The patients in the acute rejection group had a higher increase than those with stable renal function, with significant difference. Exclusion group and stable renal function of two kinds of cytokines secreted law is basically the same, but the exclusion group peak were higher than the stable renal function group. Conclusion: Detecting cytokine levels in MLC supernatant can be used as a reasonable choice of donor and prognosticator for acute rejection.