血液透析对尿毒症患者红细胞免疫功能和T细胞亚群的影响及其相关分析

The Effect of Hemodialysis on Activity of Erythrocyte Immune Function and T Lymphocyte Subsets in Patients with Uremia

目的 探讨尿毒症患者红细胞免疫功能和T淋巴细胞亚群的变化及相关关系 ,以及血液透析对其的影响。方法 采用免疫粘附法和流式细胞仪法检测 2 3例尿毒症未透析患者、2 2例尿毒症透析患者单次血液透析前后和 2 1例正常人的红细胞CR1的活性 (RBC -C3bRR、RBC -ICR)及T细胞亚群 (CD3 + 、CD4+ 、CD8+ 和CD4+ /CD8+ )的数量变化。结果 红细胞CR1的活性及T细胞亚群在尿毒症患者中呈现明显异常改变 ,血液透析可以部分改善该状况。红细胞免疫功能与T细胞亚群密切相关。血肌酐值与红细胞C3bRR呈显著正相关 (P <0 0 1) ,与CD4+ /CD8+ 均呈显著负相关 (P <0 0 1)。结论 尿毒症患者体内存在红细胞免疫粘附功能不全和细胞免疫功能障碍 ,其改变与肾脏功能受损的程度相关。红细胞免疫可能通过某种机制调控了包括T细胞亚群在内的某些免疫细胞的活性 ,从而共同发挥免疫防御作用。血液透析可以部分改善尿毒症患者红细胞免疫黏附功能不全和细胞免疫功能障碍的状况。

Objective To investigate the change of erythrocyte immune function and T lymphocyte subsets in patients with uremia and the effect of hemodialysis on them. Methods Flow cytometry and immune adherence rosette method were used to measure the activity of RBC-CR1and the changes of T lymphocyte subsets in 23 uremic patients without hemodialysis, 22 uremic patients before and after sigle hemodialysis and 21 healthy subjects as the control group. Results The activity of RBC-CR1, the number of T lymphocyte subsets significantly changed in patients with uremia, and hemodialysis could partially improve this condition. There was obvious correlation between erythrocyte immune function and T lymphocyte subsets. Serum creatinine was positively relative to the value of RBC-C 3b RR(P<0.01), and negatively relative to CD 4 +/CD 8 + ratio(P<0.01). Conclusion Erythrocyte immune adherent function and T lymphocyte subsets obviously declined in the uremic patients,and their changes were related to the damage of renal function. Erythrocyte immunity may regulate the activity of some immune cells including T lymphocyte subsets. Hemodialysis can partially improve erythrocyte immune insuffciency and cell immune dysfunction.