Abstract:

Objective　To explore the clinical characteristics of immune status and organ function in patients with pulmonary tuberculosis after liver transplantation compared with common pulmonary tuberculosis patients, and to provide scientific basis for regulating the clinical diagnosis and treatment of anti-tuberculosis. Methods　The data of inpatients in Guangzhou Chest Hospital from 2014 to 2023 were retrospectively collected. A total of 24 inpatients with pulmonary tuberculosis after liver transplantation were selected as the study group, and 31 inpatients with pulmonary tuberculosis without organ transplantation were selected as the control group. The study group were all male, and the age ranged from 37 to 75 years old, with an average age of 57 years old. The control group were all male, and the age ranged from 32 to 75 years old, with an average age of 57 years old. The data of their first test results of blood routine test, inflammatory markers, liver function, kidney function, heart function, lymphocyte subsets, and other laboratory test results were collected and compared between the two groups. The abnormal proportions of the above indicators and various types of white blood cells and platelet count were compared between the two groups. χ² test and rank sum test were used. Results　The abnormal rates of leukocytes, lymphocytes, platelets, hemoglobin, γ-glutamyltranspeptidase, creatinine, cystatin C, creatine kinase, B-type natriuretic peptide precursor, and CD3⁺, CD4⁺, and CD8⁺ lymphocyte subsets in the study group were higher than those in the control group (all P<0.05). The lymphocyte-leukocyte ratio [0.13 (0.09, 0.17)] and lymphocyte-neutrophil ratio [0.17 (0.12, 0.25)] in the study group were lower than those in the control group [0.18 (0.12, 0.21) and 0.26 (0.15, 0.33)], and the monocyte-lymphocyte ratio [0.59 (0.49, 0.96)] was higher than that in the control group [0.40 (0.33, 0.63)] (all P<0.05). Conclusion　The impaired function of major organs including liver, kidney, and heart and hypoimmunity in patients with pulmonary tuberculosis after liver transplantation are very common, which must be paid close attention to in the process of clinical treatment.

Key words:

Liver transplantation, Tuberculosis/pulmonary, Organ function, Immune function

摘要：

目的　初步探讨肝移植术后肺结核患者免疫状态与器官功能相较于普通肺结核患者的临床特点，为规范抗结核临床诊疗提供科学依据。方法　回顾性收集2014年至2023年期间广州市胸科医院住院患者的资料，以24例肝移植术后肺结核住院患者作为研究组，31例同期非器官移植肺结核住院患者作为对照组。研究组均为男性；年龄37～75岁，平均年龄57岁。对照组均为男性；年龄32～75岁，平均年龄57岁。收集两组就诊后首次血常规、炎症标志物、肝功能、肾功能、心功能、T淋巴细胞亚群等实验室检测指标结果。比较两组上述指标的异常比例、各类白细胞及血小板计数的比率。采用χ²检验和秩和检验。结果　研究组白细胞、淋巴细胞、血小板、血红蛋白、γ-谷氨酰转肽酶、肌酐、胱抑素C、肌酸激酶、B型钠尿肽前体以及CD3⁺、CD4⁺、CD8⁺ T淋巴细胞亚群检测结果异常率均高于对照组（均P<0.05）。研究组的淋巴细胞-白细胞比率［0.13（0.09，0.17）］、淋巴细胞-中性粒细胞比率［0.17（0.12，0.25）］均低于对照组［0.18（0.12，0.21）、0.26（0.15，0.33）］，且单核细胞-淋巴细胞比率［0.59（0.49，0.96）］高于对照组［0.40（0.33，0.63）］（均P<0.05）。结论　肝移植术后肺结核患者肝、肾、心等主要器官功能受损以及免疫功能低下较多，在临床诊疗过程中须予以高度关注。

关键词:

肝移植术, 结核/肺, 器官功能, 免疫功能