慢性肾衰患者红细胞免疫黏附功能和CD58的表达及蚓激酶对其的影响

Study on the adhesion function of blood cell and the expression of CD58 in patients with chronic renal failure

目的探讨慢性肾衰患者红细胞黏附功能和红细胞膜免疫分子CD58表达及其与血肌酐的关系以及中药蚓激酶对其的影响。方法选取慢性肾衰患者34例,按病因分组,口服蚓激酶肠溶胶囊治疗,并通过酵母菌黏附试验测定红细胞C3b受体花环率(RBC-C3bRR)红细胞免疫复合物花环率(RBC-ICRR)红细胞C3b受体花环促进率与抑制率,用流式细胞术测定CD58分子的表达量;正常对照组35例同法测定以上指标。结果肾衰组服用蚓激酶前后与对照组比,RBC-C3bRR、促进率、CD58均明显下降,RBC-ICRR及抑制率均明显升高(P<0.05)。肾衰组服药后与服药前相比RBC-C3bRR及促进率呈上升趋势,RBC-ICRR及抑制率呈下降趋势(P<0.05))。按病因分析:肾炎组13例、糖尿病肾病组10例、高血压肾病组9例,肾炎组较其它两组RBC-C3bRR及促进率均较低,RBC-ICRR及抑制率均较高(P<<0.05);而糖尿病肾病组与高血压肾硬化组之间以上4个指标无显著性差异(P>0.05);CD58在3组之间均无显著差异(P>0.05)。结论慢性肾衰患者红细胞免疫粘附功能和CD58分子表达均较对照组降低。肾炎组的粘附功能低于糖尿病肾病组和高血压肾病组,CD58则无差异;蚓激酶能在一定程度上提高慢性肾衰患者红细胞免疫粘附功能,但对CD58表达的影响不明显,也无显著地降低肌酐的作用。

Objective To investigate adhesion function of red blood cell ＆immune molecules CD58 expression in erythrocyle ,and to study the relation between that and creatinine in blood, and study the effect of Lumbrokinase on that. Methods We recruited 34 patients with chronic renal failure and grouped by the pathogeny and administer medicine Lumbrokinase .we measured red blood cell C3b ring rate （RBC-C3bRR）, red blood cell immune compound ring rate （RBC-ICRR）,promote rate and inhibitor rate of RBC-C3b ring by testing microzyme adhesion,we measured quantity of CD58 by flow-cell technique.We measured the same indexes in control group of 35 individuals.Results Comparing the group of renal failure with the control group before and after taking medicine Lumbrokinase ,RBC-C3bRR,promote rate and CD58 declined distinctly ,while RBC-ICRR and inhibitor rate hoisted distinctly （P〈0.05）.After taking medicine Lumbrokinase in the group of renal failure ,RBC- C3bRR and promote rate added, while RBC-ICRR and inhibitor rate declined （P〈0.05）.Analysis by pathogeny： there were 13 patients with nephritis,10 patients with diabetic nephropathy and 9 patients with hypertensive nephropathy, RBC-C3bRR and promote rate in the group of nephritis were smaller and RBC-ICRR and inhibitor rate were bigger than that of anther two groups（P〈0.05）.There was no difference in 4 indexes between the group of diabetic nephropathy and the group of hypertensive nephropathy （P〉0.05）;there were no difference in CD58 between three group （P〉0.05）.Conclusion Adhesion function of red blood cell and CD58 expression in the patients with chronic renal failure declined. Adhesion function was weaker in the nephritis group than in the diabetic and hypertensive nephropathy group. While CD58 in three group were no difference.Lumbrokinase could enhance the immune adhesion function of red blood cell in some extent, but couldn＇t affect the CD58 expression and couldn＇t reduce creatinine in blood distinctly.