中文摘要：

目的评价外周血嗜酸性粒细胞升高对肝移植后急性排斥反应（AR）的诊断价值。方法回顾性分析肝移植受者的临床资料，将术后具有完整肝活检和肝活检当天或前1天血常规和肝功能等临床数据的101例受者纳入研究。根据肝活检结果将受者分为AR组和非急性排斥反应（NAR）组，比较两组嗜酸性粒细胞绝对值和百分率等指标的差异。比较白细胞分类与发生AR的相关性。采用R0c分析确定嗜酸性粒细胞绝对值和百分率的最佳截断值，并分析其诊断AR的敏感性和特异性等。结果AR组嗜酸性粒细胞绝对值和百分率分别为（0．127±0．161）x10^9／L和（2．8±7．3）％，均显著高于NAR组的（0．071±0．100）×10^9／L和（1．0±1．1）％（P〈0．05）；外周血嗜酸性粒细胞升高与AR的发生呈明显正相关（P〈0．05）。ROC分析显示，嗜酸性粒细胞绝对值和百分率的最佳截断值分别为0．145x10^9／L和2．35％，此时约登指数最高（分别为0．17和0．185），诊断AR的敏感性和特异性分别为28．6％和88．4％、28．6％和89．9％。结论肝移植后外周血嗜酸性粒细胞的升高与AR的发生有关，对诊断AR具有较高的特异性，但敏感性较低。

英文摘要：

Objective To evaluate the predictive value of raised eosinophil count in peripheral blood in the diagnosis of acute rejection fAR） after liver transplantation （LT）. Methods The peripheral blood eosinophil count the day before or on the day of biopsy in 125 biopsies from 101 liver transplant patients was retrospectively analyzed. Patients were divided into AR group and non-acute rejection （NAR） group according to histopathologic findings. Absolute and relative eosinophil counts were compared between two groups. The optimal cut-off value for both parameters was determined by using a receiver operating characteristic curve analysis. Sensitivity and specificity of the parameters was calculated. Results Absolute and relative eosinophil counts were significantly higher in the AR group （n = 56） than in the NAR group and positively correlated with the episode of AR （r= 0. 218, P =0.015, and r = 0. 182, P = 0.042, respectively）. ROC curve analysis showed that absolute eosinophil counts of 0. 145 x 109/L and relative eosinophil counts of 2. 35% had the highest Youden index （0. 17 and 0. 185, respectively）. The cut-off value of 0. 145 x 109/L for absolute eosinophil counts and 2. 35% for relative eosinophil counts was used, respectively. The sensitivity of both absolute and relative eosinophil counts to predict AR was 28. 6%, and the specificity was 88.4~ and 89. 9%, respectively. Conclusion A raised eosinophil population in peripheral blood is associated with AR. Raised eosinophil count has a predictive value in diagnosis of AR after LT with a high specificity but low sensitivity.