尿毒症患者T淋巴细胞及其亚群改变的观察

Clinical observation of change in T-lymphocyte and its subgroups in uremic patients

目的了解尿毒症患者Ｔ淋巴细胞及其亚群的改变，探讨其临床意义。方法从外周血分离淋巴细胞，用抗人Ｔ淋巴细胞及其亚群的单克隆抗体直接测定。结果用ｔ检验及直线回归分析。结果尿毒症患者与正常组比较，Ｔ淋巴细胞总数（ＣＤ３）、辅助Ｔ淋巴细胞（ＣＤ４）数降低（Ｐ＞０．０５），抑制Ｔ淋巴细胞（ＣＤ８）数明显升高（Ｐ＜０．０１），ＣＤ４／ＣＤ８明显降低（Ｐ＜０．０５）；肾小球滤过率（ＧＦＲ）与ＣＤ８呈显著负相关（ｒ＝－０．８４８），与ＣＤ４／ＣＤ８呈显著正相关（ｒ＝＋０．７８２）。在慢性肾炎与非慢性肾炎所引起的尿毒症中，Ｔ淋巴细胞及其亚群的改变没有差异。结论在尿毒症患者。

Objective This study was to understand the change in T-lymphocyte and its subgroups(CD 3,CD 4 and CD 8) in uremic patients.Methods The T-lymphocyte and its subgroups separated from the peripheral blood were determined with antihuman monoclonal antibodies.Mean t -test and linear regression analysis were used for statistical analysis.Results In uremic patients,CD 3 and CD 4 were slightly decreased ( P <0.05) and CD 8 was significantly increased ( P <0.01). The specific value of CD 4 and CD 8 (CD 4/CD 8) in uremic patients were significantly decreased than in controls ( P <0.05).There was a significantly positive correlation between glomerular filtration rate(GFR) and CD 4/CD 8( r =+0.782),and a significantly negative correlation between GFR and CD 8( r =-0.848).Conclusion These data suggest the immunological function in uremic patients were decreasing.The changes in CD 8 and CD 4/CD 8 may be used as an index of low immunological status.