探讨Cylex ImmuKnow免疫细胞功能检测在肝移植术后感染诊断中的价值。

前瞻性研究对象为2010年7月至2012年12月在中山大学附属第三医院肝移植中心接受同种异体原位肝移植术的48例患者。所有患者均签署知情同意书，符合医学伦理学规定。根据肝移植术后有否临床感染将患者分为感染组（14例）、非感染组（34例），另设健康对照组（对照组，20例）。其中感染组男11例，女3例，平均年龄（47±10）岁；非感染组男29例，女5例，年龄（45±9）岁；对照组男10例，女10例，年龄（42±10）岁。患者肝移植术后7 d和对照组入组时，抽取外周静脉血2 ml，应用Cylex ImmuKnow免疫细胞功能测定试剂盒检测分化群（CD）4⁺淋巴细胞的三磷酸腺苷（ATP）含量，检测数据比较采用t检验。

感染组、非感染组和对照组的ATP含量分别为（178±58）、（345±62）、（467±84）mg/L，感染组ATP含量明显低于非感染组（t=-4.6，P<0.05）。Cylex ImmuKnow免疫细胞功能检测诊断肝移植术后感染的灵敏度为0.79，特异度为0.85；阳性预测值为0.69，阴性预测值为0.91。

Cylex ImmuKnow免疫细胞功能检测能够简便、快速检测患者免疫细胞功能水平，对肝移植术后感染具有一定的监测和诊断价值。

To investigate the value of Cylex ImmuKnow immune cell function assay in the diagnosis of infection after liver transplantation.

The objects of this prospective study were 48 patients undergoing orthotopic liver transplantation (OLT) in Liver Transplantation Center, the Third Affiliated Hospital of Sun Yat-sen University from July 2010 to December 2012. The informed consents of all patients were obtained and the ethical committee approval was received. According to whether the patients suffered clinical infection or not after OLT, they were divided into two groups: infection group (n=14) and non-infection group (n=34). Another 20 healthy people were enrolled as the control group. There were 11 males and 3 females in the infection group with a mean age of (47±10) years old. There were 29 males and 5 females in the non-infection group with a mean age of (45±9) years old. There were 10 males and 10 females in the control group with a mean age of (42±10) years old. Peripheral venous blood 2 ml was collected from the patients on the 7^th day after OLT or from the healthy people when enrolled in control group. The adenosine triphosphate (ATP) level in cluster of differentiation (CD) 4⁺ lymphocyte was detected using Cylex ImmuKnow kit and the testing data were compared using t test.

The ATP level in CD4⁺ cells was (178±58), (345±62), (467±84) mg/L in infection group, non-infection group and control group respectively. The ATP level in infection group was significantly lower than that in non-infection group (t =-4.6, P<0.05). The sensitivity of the Cylex ImmuKnow immune cell function assay in the diagnosis of infection after OLT was 0.79, the specificity was 0.85, the positive predictive value was 0.69, and the negative predictive value was 0.91.

Cylex ImmuKnow immune cell function assay can simply and quickly detect the immune cell function. It plays a role in monitoring and diagnosing the infection after OLT.