Abstract:

Objective To investigate the application value of dynamic monitoring of lymphocyte subsets （including T，B and NK cells）after lung transplantation. Methods Flow cytometry was used to dynamically monitor the changes of lymphocyte subsets at different time points before and after lung transplantation in two patients. Results Two recipients presented different changes of lymphocyte subsets before and after lung transplant. The preoperative lymphocyte subsets were in normal level in one recipient，the T lymphocyte subgroup returned to reference range nine days after transplant，the absolute number of NK cells remained low，the CD4/CD8 level first increased and then decreased postoperatively in this patients. The lymphocyte subsets has been restored to normal levels 6 month after transplant. In case 2，the lymphocyte subsets were severely reduced before surgery，and the absolute number of CD3+CD8+ T lymphocytes returned to normal level 7 days after surgery. CD3+CD4+ T lymphocytes and CD4/CD8 remained low，while NK cells and B cells fluctuated slightly and were below the reference range at most time points. Conclusion Dynamic monitoring of lymphocyte subsets after lung transplantation cantimely evaluate the immune status of patients，provide reference for individualized diagnosis and treatment and timely adjustment of medication regimen. 

Key words:

Lymphocyte subsets, Lung transplantation, Silicosis, Paraquat

摘要：

目的 探讨淋巴细胞亚群（包括 T、B、NK 细胞）动态监测在肺移植术后的应用价值。方法 采用流式细胞术动态监测 2 例肺移植患者术前及术后不同时间点淋巴细胞亚群变化情况。结果 2 例肺移植患者术前及术后淋巴细胞亚群呈现不同的变化，病例 1 术前淋巴细胞亚群在正常水平，术后 9 d T 淋巴细胞亚群绝对数恢复至参考值范围，NK 细胞绝对数持续偏低，该患者术后 CD4/CD8 先低后高，术后6 个月淋巴细胞亚群已恢复至正常水平。病例 2 术前淋巴细胞亚群严重降低，术后 7 d CD3+CD8+ T 淋巴细胞绝对数恢复至正常水平，CD3+CD4+ T淋巴细胞和 CD4/CD8 持续低下，NK 细胞和 B 细胞稍有波动，多数时间点低于参考值范围。 结论 肺移植患者术后淋巴细胞亚群动态监测，可及时评估患者免疫状态，为患者个体化诊疗和及时调整用药方案提供参考。

关键词:

淋巴细胞亚群 , 肺移植 , 矽肺 , 百草枯