黄芪对血液透析患者外周血调节性T细胞的影响及意义

Effect of Astragalus Mongholicus on Changes of Regulatory T Cells of Peripheral Blood in Hemodialysis Patients and Its Clinical Significance

目的通过观察尿毒症患者血液透析及黄芪治疗前后外周血中调节性T细胞的水平,研究血液透析及黄芪对尿毒症患者调节性T细胞的影响,探讨血液透析及黄芪对尿毒症患者的免疫调节作用。方法随机选取初诊尿毒症患者58例,并随机分为单纯血液透析组、血液透析+黄芪组,并设30例健康志愿者为健康对照组。采用流式细胞仪检测外周血CD4^+T细胞、CD4^+FoxP3^+T细胞、CD4^+CD25^+FoxP3^+T细胞水平。结果初诊尿毒症患者单纯血液透析组CD4^+CD25^+Treg比例均明显低于健康对照组及血液透析+黄芪组(P<0.01);治疗8周后与健康对照组相比无统计学差异(P>0.05)。而尿毒症患者CD4^+T细胞在治疗后均明显降低,且黄芪治疗组更明显,治疗8周后已达正常水平。结论血液透析和黄芪联合治疗有利于纠正尿毒症患者调节性T细胞的水平,改善机体的免疫功能。

Objective To evaluate the variation of regulatory T cells （Tregs） in uremic patients before and after Astragalus mon-gholicus and hemodialysis treatment ,and to explore their effect on Tregs and their clinical significance .Methods Fifty eight uremic patients were randomly divided into two groups ,hemodialysis group and hemodialysis plus Astragalus mongholicus group ,and 30 normal healthy donors were assigned to control group.The flow cytometric analysis（FCM） was performed to detect the percentage of CD 4＋T cells,CD4＋Foxp3 cells and CD4＋CD25＋Foxp3＋T cells of the uremic patients in the peripheral blood in each group .Results The level of Treg in untreated uremic patients was significantly lower than in control group and treatment group .The population of Treg in hemodialysis plus Astragalus mon-gholicus group was higher than in hemodialysis group （P〈0.05）.And after 8-week treatment,which was almost the same to that in control group（P〉0.05）.While the level of CD4＋T cells in uremic patients declined obviously after treatment ,and more obvious in the Astragalus treated group,it reached normal level after 8-week treatment.Conclusion The expression of CD4＋CD25＋Tregs in uremic patients is lower than in control group,and the Tregs increase evidently after treatment ,which explains that immune function disorder exists in uremic patients . While hemodialysis and Astragalus mongholicus can correct this immune imbalance and improve immune function .