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目的分析探讨移植肾急性排斥组织中C4d、CD3、CD4、CD8、CD138的表达。方法收集我院2010年3月至2013年10月经病理学确认为急性排斥反应移植肾穿刺标本136例,依据Banff 2007标准将研究对象分为5组,利用免疫组织化学染色计数测定各组C4d、CD3、CD4、CD8、CD138阳性表达情况并计算CD4/CD8值。结果急性抗体介导性排斥反应组C4d染色均为阳性,急性T细胞介导性排斥反应组C4d染色均为阴性;CD3、CD4、CD8阳性细胞数及CD4+/CD8+值急性T细胞介导性排斥反应组高于急性抗体介导性排斥反应组,差异有统计学意义(P<0.01),急性T细胞性排斥Ⅰ、Ⅱ级组高于疑为急性T细胞介导性排斥组,差异有统计学意义(P<0.01),急性T细胞性排斥Ⅱ级组高于急性T细胞性排斥Ⅰ级组,差异具有统计学意义(P<0.05),急性抗体介导性排斥反应Ⅰ级组与急性抗体介导性排斥反应Ⅱ级组差异无统计学意义(P>0.05);CD138阳性细胞急性抗体介导性排斥反应组大于急性T细胞介导性排斥反应组,差异有统计学意义(P<0.01),急性抗体介导性排斥反应Ⅱ级组高于急性抗体介导性排斥反应Ⅰ级组,差异具有统计学意义(P<0.05),急性T细胞介导性排斥反应3组比较,差异无统计学意义(P>0.05)。结论 C4d的表达和CD3、CD4、CD8、CD138阳性细胞数以及CD4+/CD8+值与肾移植急性排斥反应的类型及反应程度密切相关,检测C4d、CD3、CD4、CD8、CD138在移植肾急性排斥组织中表达情况,对于探讨移植肾早期急性排斥反应发生具有重要意义。
Objective To investigate the expression of C4d, CD3, CD4, CD8 and CD138 in acute rejection of renal allograft. Methods 136 cases of transplanted renal biopsy specimens confirmed as acute rejection by pathology in our hospital from March 2010 to October 2013 were divided into 5 groups according to Banff 2007 standard.The C4d, CD3, CD4, CD8, CD138 positive expression and calculate CD4 / CD8 value. Results C4d staining was positive in acute antibody-mediated rejection group and C4d staining in acute T cell-mediated rejection group. The number of CD3, CD4, CD8 positive cells and CD4 + / CD8 + T cell-mediated rejection The reaction group was higher than the group of acute antibody-mediated rejection, the difference was statistically significant (P <0.01), acute T cell rejection group Ⅰ, Ⅱ higher than the group suspected of acute T cell-mediated rejection, the difference was statistically (P <0.01). Acute T-cell rejection in grade Ⅱ group was higher than that in acute T-cell rejection gradeⅠ group (P <0.05), and the level of acute antibody-mediated rejection The level of antibody-mediated rejection in grade Ⅱ group was not significantly different (P> 0.05). The level of CD138 positive cells in acute antibody-mediated rejection was higher than that in acute T cell-mediated rejection (P < 0.01). The levels of acute antibody-mediated rejection in group Ⅱ were significantly higher than those in group Ⅰ of acute antibody-mediated rejection (P <0.05), and those in acute rejection of T cells were significantly lower than those in group Ⅰ No statistical significance (P> 0.05). Conclusions The expression of C4d and the number of CD3, CD4, CD8, CD138 positive cells and CD4 + / CD8 + are closely related to the type and degree of acute rejection of renal allograft. The expressions of C4d, CD3, CD4, CD8 and CD138 in acute rejection of renal allograft In the expression of the early stage of acute renal transplant rejection is of great significance.