摘要目的：研究膜型人类白细胞抗原G（mHLA-G）及其受体免疫球蛋白样转录物2（ILT2）在淋巴细胞上的表达率与肾移植术后发生排斥反应和巨细胞病毒（ CMV）感染的相关性。方法选取2014年2月至2016年2月解放军第三〇九医院全军器官移植中心施行初次肾移植受者88例，按照术后是否单纯发生排斥反应，将受者分为排斥反应组（12例）和肾功能稳定组（41例）；肾移植术后未发生排斥反应，仅单纯发生CMV活动性感染为CMV阳性组（24例）；肾移植术后未发生排斥反应，曾经发生CMV活动性感染，后又转阴的受者为CMV阴性组（11例）。通过流式细胞术检测mHLA-G、ILT2在T、B淋巴细胞的表达，分析不同组间差异。结果肾移植术后发生排斥反应时T、B淋巴细胞mHLA-G的表达率最低（0.42％±0.35％、0.88％±0.47％），与肾功能稳定组、CMV阳性组差异均有统计学意义（均P＜0.01）；而在CMV阳性组（CMV活动性感染时），T、B淋巴细胞mHLA-G的表达率最高（1.31％±0.69％、2.01％±0.91％），与排斥反应组差异有统计学意义（均P＜0.001）；B淋巴细胞mHLA-G的表达率在CMV阳性组与CMV阴性组差异有统计学意义（P＜0.05）。 B淋巴细胞ILT2表达率在4组间差异无统计学意义（P＞0.05），T细胞ILT2的表达率在CMV阳性组较高（36.91％±14.91％），与其余3组间差异有统计学意义（均P＜0.01）。结论肾移植受者术后mHLA-G在T、B淋巴细胞的表达过低容易发生排斥反应。 mHLA-G和ILT2在淋巴细胞表达过高容易发生CMV活动性感染。

abstractsObjective To study the expression of membrane HLA-G ( mHLA-G) and the receptor immunoglobulin-like transcript 2 ( ILT2 ) on lymphocyte and find their association with rejection and cytomegalovirus ( CMV ) infection after renal transplantation .Methods A total of 88 cases of renal transplant recipients for the first time from February 2014 to February 2016 were studied in this work . Recipients can be divided into rejection group (n=12) and stable renal function group (n=41) according to whether rejection occurred .Recipients only infected CMV not developed rejection were included in the CMV positive group ( n =24 ) .CMV negative group ( n =11 ) including CMV negative recipients once infected CMV .The expression of mHLA-G and ILT2 on lymphocytes were detected by flow cytometry , and the differences among different groups were analyzed .Results The data showed that after renal transplantation,T and B lymphocytes mHLA-G expression rate was the lowest in the rejection group (0.42%± 0.35%, 0.88%±0.47%), having significant difference with renal function stable group and CMV positive group (all P<0.01).In CMV positive group the expression of mHLA-G on T and B lymphocytes was the&nbsp;highest (1.31%±0.69%,2.01%±0.91%), having significant difference with rejection group ( P <0.001).The expression of mHLA-G on B cell was statistically significantly different between CMV positive group and CMV negative group (P<0.05).There was no significant difference in ILT2 expression on B cell among the four groups (P>0.05).The expression rate of ILT2 on T cells was higher in the CMV positive group (36.91% ±14.91%),having significant difference with the other three groups (P <0.01). Conclusions Low expression of mHLA-G on T and B lymphocytes may predict rejection after renal transplantation.High expression of mHLA-G and ILT2 on lymphocytes is prone to CMV infection after renal transplantation .