尿毒症血液透析患者血清GH/IGF-1、IL-2、IL-4水平的变化及相关性研究

Changes and correlation of serum GH/IGF-1,IL-2,and IL-4 levels in hemodialysis patients

目的观察尿毒症血液透析(HD)患者血清GH/IGF-1、IL-2、IL-4水平的变化及其相互关系,以探讨其在免疫-内分泌平衡中的作用。方法选择终末期尿毒症行HD患者35例及健康对照者20例,于清晨空腹采血,采用双抗体夹心ABC-ELISA法测定血清IGF-1、IL-2、IL-4的含量,化学发光法测定GH水平,多元相关分析研究它们之间的关系。结果HD患者血清细胞因子IGF-1、IL-2水平与对照组比较明显升高,差异均有显著性(P<0.01);GH、IL-4与对照组比较降低,但无显著性差异(P>0.05)。多元相关分析表明HD患者血清GH与IGF-1(r=-0.38,P<0.05),GH与IL-4(r=-0.42,P<0.05)均呈显著负相关,而与IL-2无明显相关性;IGF-1与IL-2(r=0.45,P<0.01),IL-2与IL-4(r=0.53,P<0.01),IL-4与IGF-1(r=0.57,P<0.01)均呈显著正相关。结论HD患者血清IL-2、IL-4水平变化与GH/IGF-1改变相关联,这种变化及其相互影响是免疫—内分泌平衡失调的因素之一。

Objective To observe the changes and correlation of serum levels of GH/IGF-1, IL-2, and IL-4 in hemodialysis （HD） patients for exploring its effects on i mmunoendocrine. Methods Thirty-five HD patients and twenty healthy control subjects were recruited for the study. Blood was drawn after an overnight fast. The serum levels of IGF-1, IL-2, and IL-4 were measured by sandwich enzyme-linked immunosorbent assay （ELISA） ; the serum GH level was determined by chemiluminescence assay. The multiple correlation were also analyzed between parameters including GH, IGF-1, IL-2, and IL-4. Results The levels of serum IGF-1 [ （252.87 ± 82.66） ng/mL] and IL-2 [ （164.35 ± 60.86） pg/mL] markedly increased in HD group, which were significandy different from normal controls [ IGF-1 （60.42 ± 14.52） ng/mL and IL-2 （114.32 ± 53.84） pg/mL] （P 〈 0.01, 0.01）. Serum GH and IL-4 levels in HD group had a litde descent but there were not significandy different from those of controls （ P 〉 0.05） ; serum GH level in HD patients was negatively correlated with IGF-1 （ r = - 0.38, P 〈 0.05） and IL-4 （r = - 0.42, P 〈 0.05 ）; no significant correlation was observed between GH and IL-2; serum IGF-1 levels were positively correlated with IL-2 （ r = 0.45, P 〈 0.01 ） and IL-4 （ r = 0.57, P 〈 0.01 ） ; and also, there was positive correlation between serum IL-2 and IL-4 （ r = 0.53, P 〈 0.01 ）. Conclusion These data suggest that the imbalance of serum cytokines including IL-2 and IL-4 is associated with the altered GH/IGF-1 axis in HD patients, which probably play a role in the dysfunction of immunoendocrine.