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目的:研究肾移植患者术后早期外周血单核细胞中Toll样受体4(TLR4)的表达改变及其与急性排异反应的关系。方法:首次接受肾移植手术受者60例,流式细胞术测定受者肾移植术前及术后第7、14、21天外周血单核细胞TLR4、CD80表达的百分率;根据肾移植术后两周内发生排斥与否将患者分为排斥组(13例)和非排异组(47例)。20例健康成年志愿者标本为正常对照组。急性排异反应诊断标准依据临床表现、实验室检查、超声及移植肾穿刺活检等综合判断。结果:术前外周血单核细胞中TLR4、CD80即有表达,TLR4与对照组相比有统计学意义;术后1周两者表达到达顶峰,其后逐渐下降,排斥组外周血单核细胞TLR4、CD80表达峰值较肾功能正常组明显升高(P<0.05),且持续时间较长。结论:TLR4、CD80在肾移植术后早期表达升高,并可增加肾移植术后急性排斥反应发生的风险。
Objective: To investigate the expression of TLR4 in peripheral blood mononuclear cells (PBMC) after renal transplantation and its relationship with acute rejection. Methods: The first recipients of renal transplant recipients were 60 cases. The percentage of TLR4 and CD80 expression in peripheral blood mononuclear cells before and after operation were measured by flow cytometry. Exclusion within two weeks or not divided patients into rejection group (13 cases) and non-rejection group (47 cases). Twenty healthy adult volunteers were normal control group. Diagnostic criteria for acute rejection based on clinical manifestations, laboratory tests, ultrasound and renal biopsy and other comprehensive judgment. Results: Preoperative TLR4 and CD80 expression in peripheral blood mononuclear cells, TLR4 compared with the control group was statistically significant; 1 week after the two expression reached its peak, then gradually decreased, rejection group of peripheral blood mononuclear cells The peak of TLR4 and CD80 expression was significantly higher than that of normal renal function group (P <0.05), and the duration was longer. Conclusion: The expressions of TLR4 and CD80 are elevated early after renal transplantation and may increase the risk of acute rejection after renal transplantation.