促红细胞生成素对慢性肾衰竭患者免疫功能的影响

The effects of EPO on immunofunctions in patients with chronic renal failure

目的 探讨重组人促红细胞生成素(rh -EPO)对慢性肾衰竭患者红细胞免疫、体液免疫、细胞免疫、红细胞膜流动性等方面的影响。方法 6 9例慢性肾衰竭患者被随机分成3组,每组各2 3例。A组:采用透析和EPO治疗;B组:单纯采用EPO治疗;C组:为对照组,不采用透析,不进行EPO治疗。采用改良郭氏法测定红细胞免疫功能;用荧光偏振法测定红细胞膜脂分子流动性;用放射免疫法测定血清免疫球蛋白;用APAAP酶联免疫分析法测定T淋巴细胞亚群。同时观察3组患者治疗期间的感染发生率。结果 主要免疫学检测指标在药物治疗前在A、B和C组间没有统计学差异。A、B两组患者治疗8周后,C3b、RFER、IgG、IgA、CD3亚群、CD4亚群及CD4 /CD8比率显著升高,与对照组相比统计学差异有非常显著性,而RFIR %无明显变化,与对照组相比统计学差异无显著性。结论:rh -EPO可以提高CRF患者的免疫功能,降低患者的感染率。

Objective To investigate the effect of EPO on RBC immunity, humoral and cellular immunity and fluidity of RBC membrane in patients with chronic renal failure(CRF). Methods Sixty-nine patients with CRF were divided into three groups. Group A patients accepted hemodialysis and were treated with EPO. Group B patients were treated with EPO and didn't accept hemodialysis. Group C patients didn't accept EPO treatment and hemodialysis. After 8 weeks treatment, RBC immune functional parameters were detected by the modified Gao's methods; the subpopulations of T lymphocyte were analyzed with APAAP method; Immunoglobulins were measured with radio-immuno, assay (RIA) and RBC membrane fluidity was determined by fluorescence spectrophotometer method. In addition, the infection rate of patients with CRF in different group was compared. Results The parameters of immune functions of patients with CRF were comparable between groups before treatment. After treated with EPO for 8 weeks, RBC numbers and Hb level were significantly increased in patients of group A and Group B, but not in patients of group C. C3b, RFER, IgG and IgA were increased in patients of groups A and groups B and had statistic differences as compared with that in patients of group C (P<0.01). The number of CD3 and CD4 subpopulations, but not CD8 subpopulation were also increased and CD4/CD8 ratio was raised in patients of group A and group B. These parameter changes between either group A or group B and group C have statistic differences. The infection rate was decreased in patients of group A and group B and the difference of infection rate between either group A or group B and group C has statistic significance. Conclusion These results indicated that EPO treatment in patient with CRF significantly modified patients' immune functions and decreased patients' infection rate.