腹膜透析液中添加黄芪对腹腔巨噬细胞功能的影响

Addition of astragalus into peritoneal dialysate improve peritoneal macrophages function in CAPD patients

目的:通过在腹膜透析液(PDF)中添加黄芪注射液后观察患者腹腔巨噬细胞功能的变化。 方法:采用自 身对照的方法,在28例连续性不卧床腹膜透析(CAPD)治疗患者的PDF中添加黄芪注射液(20ml/2L)后,比较患 者透出液巨噬细胞活性、吞噬功能及肿瘤坏死因子α(TNF α)和一氧化氮(NO)分泌的变化情况,以及在不同剂量 黄芪注射液的作用下,巨噬细胞活性和细胞因子分泌改变的影响。 结果:用药前后患者透出液中TNF α含量未 出现显著变化,分别为(100±63)ng/Lvs(116±60)ng/L(P=0.192);腹腔巨噬细胞噬菌率分别为(34.8±12.7)% vs(43.4±9.3)%(P<0.01),杀菌率分别为(23.6±7.7)%vs(32.1±10.2)%(P<0.01);巨噬细胞经脂多糖 (LPS)刺激其噻唑蓝(MTT)还原能力检测值(A值)分别为0.156±0.051vs0.230±0.097(P<0.01)。上清液中 NO含量分别为(7.72±2.36)μmol/Lvs(12.22±2.81)μmol/L(P<0.01)。上清液中TNF α含量分别为(1406± 358)ng/Lvs(1925±389)ng/L(P<0.01)。分离的巨噬细胞在不同条件下共同孵育后,PDF组和RPMI1640组巨 噬细胞上清液中TNF α、NO含量和沉渣MTT还原能力较含黄芪注射液各组明显降低(P<0.01);黄芪组上清液中 TNF α、NO含量和沉渣MTT还原能力以1%和2%黄芪组改善较为明显。

Objective: To investigate the effect of Astragalus on peritoneal macrophages function in stable continuous ambulatory peritoneal dialysis(CAPD) patients. Methods: 28 stable CAPD patients were included in this study.All the patients were treated with peritoneal dialysis fluid containing Astragalus(20 ml/2 L) in vivo for one week.Peritoneal macrophages function such as phagocytosis ratio、bactericidal ratio、excretion of cytokines(TNF-α and NO) and mitochondrial dehydrogenases activity(MTT assay) were examined ex vivo just before and after the treatment. In vitro,peritoneal macrophages isolated from effluent were incubated with RPMI 1640、CDF or CDF containing various concentrations of Astragalus. Then peritoneal macrophages function mentioned above were examined again and compared. Results:No significant difference was found in TNF-α level in effluent between before and after the treatment (100±63)ng/L vs (116±60)ng/L, (P=0.192). While comparing with pre-treatment, peritoneal macrophages function was improved significantly after the addition of Astragalus into dialysate (phagocytosis ratio: (34.8±12.7)% vs (43.4±9.3)%,P<0.01; bactericidal ratio: (23.6±7.7)% vs ( 32.1±10.2)%,P<0.01; NO: (7.72±2.36)μmol/L vs (12.22±2.81)μmol/L,P<0.01; TNF-α: (1406±358)ng/L vs (1925±389)ng/L,P<0.01; MTT: 0.156±0.051 vs 0.230± 0.097,P<0.01.In vitro, there were no differences between RPMI 1640 group and CDF group in levels of TNF-α、NO and mitochondrial dehydrogenases activity (P>0.05).The results in these two groups were significantly lower than those in Astragalus groups(P<0.01).No significant difference was found in levels of TNF-α、NO and mitochondrial dehydrogenases activity between 1% Astragalus group and 2% Astragalus group (P>0.05). While significant decreasing in NO level and mitochondrial dehydrogenases activity were observed in 8% Astragalus groups as compared with those in 2% Astragalus group(P< 0.05). Conclusion:The addition of Astragalus into peritoneal dialysis fluid can improve peritoneal macrophages function in CAPD patients, enhance host defense of peritonium cavity.