【摘要】：目的研究Thl7細胞及其相關因子白細胞介素-17（IL-17）于肝移植急性排斥反應中的臨床作用及意義。 方法收集2011年1月至2012年12月于大連醫(yī)科大學附屬第二醫(yī)院行肝移植手術的患者28例，然后根據移植肝組織病理穿刺活檢診斷結果將進行肝移植的28例患者分為兩組，分別為：急性排異反應組(急性排斥組，6例)和無排斥反應的穩(wěn)定組(穩(wěn)定組，，22例)，另外選取15名健康體檢者作為健康對照組。急性排斥組及穩(wěn)定組在移植術后3天和7天，行肝穿刺活檢病理檢查；同時用流式細胞儀檢測三組受檢者外周血中CD45+T淋巴細胞中Th17細胞比例，用酶聯免疫吸附實驗（ELISA）檢測三組受檢者血清中IL-17含量。 結果 1.移植肝組織病理穿刺活檢診斷顯示急性排斥組中的患者，隨著移植術后時間的延長，排斥反應會逐漸增強，且術后7天的病理改變結果顯示較術后3天的病理改變嚴重。 2.急性排斥組患者外周血中Th17細胞比例在術后3天及7天較穩(wěn)定組及健康對照組均明顯增多（P＜0.05），且術后7天Th17細胞比例明顯高于3天（P＜0.05）；穩(wěn)定組和健康對照組比較無明顯差別(P＞0.05)。 3.急性排斥組術后3天及7天，患者血清中IL-17含量較穩(wěn)定組及健康對照組均有明顯升高（P＜0.05），且術后7天IL-17含量明顯高于3天（P＜0.05）； 4.穩(wěn)定組患者血清中的IL-17含量于術后3天及7天較健康對照組相比明顯升高(P＜0.05)，但術后7天IL-17含量與術后3天相比無明顯差別（P＞0.05）。 結論Thl7細胞及其相關因子白細胞介素-17（IL-17）在肝移植急性排斥反應的發(fā)生、發(fā)展中可能起著極其重要的作用，對肝移植患者外周血中Th17細胞及IL-17的檢測可作為肝移植急性排斥反應早期診斷的指標。
[Abstract]:Objective to study the clinical role and significance of Thl7 cells and its related factor IL-17 (IL-17) in acute rejection of liver transplantation. Methods from January 2011 to December 2012, 28 patients undergoing liver transplantation in the second affiliated Hospital of Dalian Medical University were collected, and then 28 patients undergoing liver transplantation were divided into two groups according to the diagnosis results of pathological puncture and biopsies of liver tissue. Acute rejection group (acute rejection group, n = 6) and stable group without rejection (stable group, n = 22). Another 15 healthy subjects were selected as healthy control group. Liver biopsies were performed in acute rejection group and stable group 3 and 7 days after transplantation. At the same time, the proportion of Th17 cells in CD45 T lymphocytes in peripheral blood of the three groups was detected by flow cytometry, and the content of IL-17 in serum of the three groups was detected by enzyme-linked immunosorbent assay (ELISA). Result 1. Pathological biopsies of liver transplantation showed that the rejection of patients in acute rejection group increased gradually with the prolongation of transplantation time, and the pathological changes of 7 days after operation were more serious than those of 3 days after operation. 2. The proportion of Th17 cells in peripheral blood of patients with acute rejection was significantly higher than that of stable group and healthy control group on the 3rd and 7th day after operation, and the proportion of Th17 cells on the 7th day after operation was significantly higher than that on the 3rd day (P < 0.05). There was no significant difference between the stable group and the healthy control group (P > 0.05). 3. The content of IL-17 in serum of acute rejection group was significantly higher than that of stable group and healthy control group on the 3rd and 7th day after operation, and the content of IL-17 on the 7th day after operation was significantly higher than that on the 3rd day (P < 0.05). The serum IL-17 content in the stable group was significantly higher than that in the healthy control group on the 3rd and 7th day after operation, but there was no significant difference in IL-17 content between the stable group and the healthy control group on the 7th day after operation (P > 0.05). Conclusion Thl7 cells and its related factor IL-17 (IL-17) may play an important role in the occurrence and development of acute rejection in liver transplantation. The detection of Th17 cells and IL-17 in peripheral blood of patients with liver transplantation can be used as an index for early diagnosis of acute rejection of liver transplantation.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R657.3

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