关键词: 肾功能衰竭 , 肾移植 , 辅助性 T 细胞 17 , 调节性 T 细胞 , 肺部感染 , 预测

Abstract:

Objective To explore the expression of helper T cell 17（Th17）/regulatory T cell（Treg）levels in kidney transplant patients and their predictive value for the occurrence of pulmonary infections. Methods A total of 74 patients with kidney transplantation from January 2020 to December 2022 in People's Hospital ofXinjiang Uygur Autonomous Region were analysed in the study. The proportion of Th17 and Treg cells in peripheral blood was detected before and 2 months after surgery，and the Th17/Treg level was calculated. Patients werefollowed up for 1 year after surgery，and were divided into infected group and non infected group accordingto postoperative pulmonary infection. We focused on the ratio of Th17/Treg cells in renal transplant patients，and analyzed the predictive value of Th17/Treg ratio for postoperative pulmonary infection in renal transplant patients. Results There was a statistical significant difference in preoperative Th17/Treg ratio in kidney transplant patients with or without smoking history，diabetes，hypoproteinemia，and pulmonary infection history（P ＜ 0.05）. During the follow-up period of 74 kidney transplant patients，there were 21 cases of concurrent pulmonary infections，with an incidence rate of 28.38%（21/74）. The proportion of smoking history，diabetes，hypoproteinemia，and pulmonary infection history in the infected group was higher than that in the uninfected group，and the Tac blood concentration was higher than that in the uninfected group 2 months after surgery. The proportion of Treg cells in peripheral blood before and after surgery was lower than that in the non infected group，while the proportion of Th17 cells and Th17/Treg ratio were higher than those in the non infected group（P ＜ 0.05）. The results of plotting the receiver operating characteristic（ROC）curve showed that the AUC values of Th17，Treg cell ratio，and Th17/Treg level predicting postoperative pulmonary infection in kidney transplant patients were all ≥ 0.7 before surgery and 2 months after surgery，with a certain predictive value. Among them，the preoperative Th17/Treg ratio had a more ideal predictive value. Conclusion The elevated level ofTh17/Treg in renal transplant patients may participate in the process of pulmonary infection in renal transplant patients，and the high expression of Th17/Treg may be related to a history of smoking，diabetes and other risk factors for pulmonary infection；Preoperative examination of Th17/Treg ratio in patients can effectively predict the risk of postoperative pulmonary infection. 

Key words:

Renal failure , Kidney transplantation , Helper T cells 17 , Regulatory Tcells, Pulmonary infection, Prediction