单核细胞上低水平的HLA-DR表达作为肝移植后细菌性败血症的预后标志物
Low HLA-DR expression on monocytes as a prognostic marker for bacterial sepsis after liver transplantation.
作者信息
van den Berk J M, Oldenburger R H, van den Berg A P, Klompmaker I J, Mesander G, van Son W J, van der Bij W, Sloof M J, The T H
机构信息
Department of Clinical Immunology, University Hospital, Groningen, The Netherlands.
出版信息
Transplantation. 1997 Jun 27;63(12):1846-8. doi: 10.1097/00007890-199706270-00026.
BACKGROUND
Low HLA-DR expression on monocytes is associated with an increased risk of infection after surgery or trauma. We determined the value of this parameter as a marker for sepsis after liver transplantation.
METHODS
The percentage of monocytes expressing HLA-DR was determined by flow cytometry before and after liver transplantation in nine patients. Five lung and 20 kidney transplant recipients served as controls.
RESULTS
Bacterial sepsis occurred in 5 of 9 liver transplant patients and 0 of 24 control patients. Monocyte HLA-DR expression decreased <50% in all five patients with sepsis. HLA-DR expression dropped before (n=4) or at the time of sepsis (n=1), and remained low for 13 weeks. HLA-DR expression remained >50% in the four liver transplant patients without sepsis. Only 1 of 25 control patients had persistently low monocyte HLA-DR expression.
CONCLUSIONS
Monitoring of monocyte HLA-DR expression may be helpful in identifying liver transplant patients who have an increased risk of imminent bacterial sepsis.
背景
单核细胞上低水平的HLA - DR表达与手术或创伤后感染风险增加相关。我们确定了该参数作为肝移植后脓毒症标志物的价值。
方法
通过流式细胞术测定9例患者肝移植前后表达HLA - DR的单核细胞百分比。5例肺移植受者和20例肾移植受者作为对照。
结果
9例肝移植患者中有5例发生细菌脓毒症，24例对照患者中无1例发生。所有5例脓毒症患者的单核细胞HLA - DR表达均下降至<50%。HLA - DR表达在脓毒症发生前（n = 4）或发生时（n = 1）下降，并持续低水平达13周。4例未发生脓毒症的肝移植患者的HLA - DR表达保持>50%。25例对照患者中只有1例单核细胞HLA - DR表达持续较低。
结论
监测单核细胞HLA - DR表达可能有助于识别即将发生细菌脓毒症风险增加的肝移植患者。
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