【摘要】 目的:观察移植肾功能稳定的长期受者(>10年)外周血B细胞亚群分布特征及其相关因素。方法:54名肾移植受者接受流式细胞仪检查,测算外周血总B细胞、未转化记忆B细胞、转化记忆B细胞、双阴性B细胞(CD19+CD27-Ig D-)比例及数量(个/微升)。患者均服用包括环孢霉素的免疫抑制治疗。术后时间16.33±5.98年,GFR:91.63±11.28 m L/min/1.73 m2。结果:1长期肾移植患者外周血B细胞中幼稚B细胞最多(37.92%±22.06%),未转化记忆B细胞最少(16.23%±11.10%)。B细胞亚群数量与白细胞总数、中性粒细胞比例等相关。2以上述条件为控制因素行相关分析,转化记忆B细胞比例和GFR相关(r=-0.279,P=0.045),双阴性B细胞数量和环孢霉素浓度相关(r=-0.300,P=0.029)。线性回归显示双阴性B细胞数目与环孢霉素浓度相关(R2=0.123,P=0.049)。3按GFR将患者分为肾功能减退组(GFR<90 m L/min/1.73 m2,n=19)和肾功能正常组(GFR≥90 m L/min/1.73 m2,n=35)。前者转化记忆B细胞比例显著升高(23.61%±10.96%vs.17.48%±8.91%,P=0.030)。按环孢霉素谷浓度将患者分为低浓度组(<64 mmol/L,n=28)和高浓度组(≥64 mmol/L,n=26),前者双阴性B细胞数量显著升高(13.74±10.70 vs. 8.14±6.72/μL,P=0.027)。转化记忆B细胞比例与GFR分组相关(r=-0.326,P=0.018),双阴性B细胞数量和环孢霉素浓度分组相关(r=-0.350,P=0.01)。结论:移植肾功能稳定的长期存活受者(>10年)外周血幼稚B细胞较多。转化记忆B细胞增多与移植肾功能减退相关,增多的双阴性B细胞和低孢霉素浓度治疗相关。更多还原

【Abstract】 Objective: To investigate the peripheral B lymphocyte phenotype in long-term survival allograft kidney transplant recipients. Methods: Peripheral B lymphocyte phenotype was detected in 54 Allograft kidney transplant recipients. The number(/μL) and percentage of total B cell, unswitched memory B cell, switched B cell, double negative B cell(CD19+CD27-Ig D-)were recorded, respectively. The average estimated Glomerular Filtration Rate(GFR) was 91.63±11.28 m L/min/1.73 m2. The average time(years) after kidney transplant was 16.33 ±5.98 years. All patients had the same immunosuppressant treatment including cyclosporine. Results: 1 Na?ve B cells predominated in the peripheral B lymphocytes(37.92%±22.06%), while unswitched B cells were the least(16.23%±11.10%). The number of B lymphocytes subtypes correlated with the number of peripheral leukocytes and the percentage of neutrophils. 2 Correlation analysis indicated that, the percentage of switched B cells related to GFR(r=-0.279, P=0.045). Besides, the number of double negative B cells related to the trough level of cyclosporine(r=-0.300, P=0.029). Linear regression analysis indicated that the number of double negative B cells correlated with cyclosporine(R2=0.123, P=0.049). 3 Patients in the impaired allograft function team(GFR<90 m L/min/1.73 m2,n=19) had higher percentage of switched memory B cells(23.61%±10.96% vs.17.48%±8.91%, P=0.030) than the normal allograft function team(GFR≥90 m L/min/1.73 m2,n=35). Patients with lower cyclosporine trough level(<64 mmol/L, n=28) had more double negative B cells(13.74±10.70 vs. 8.14±6.72/μL, P=0.027) than the higher cyclosporine trough level patients(≥64 mmol/L, n=26). The percentage of switched memory B cells correlated with the normal/impaired allograft function team(r=-0.326, P=0.018). The number of double negative B cells correlated with the higher/lower cyclosporine team(r=-0.350, P=0.01). Conclusions: In the long-term survival kidney transplant patients with stable allograft function, na?ve B cells predominated in the peripheral B lymphocytes. Switched memory B cells correlate with impaired allograft kidney function. Increased double negative B cells correlate with low cyclosporine trough level.更多还原