尿毒症患者免疫功能与营养状态的相关性分析

Correlation analysis between immune function and nutritional status in uremic patients

目的了解尿毒症患者免疫功能与营养状态的关系,为进一步研究尿毒症患者机体免疫功能的变化提供一定的理论依据。方法选取2013年10月至2014年5月于该院肾病内科确诊为尿毒症且未进行透析治疗的患者75例为观察组,同期15名健康体检者为对照组,检测两组空腹静脉血液标本中的T细胞亚群CD3+、CD4+、CD8+、CD4+/CD8+和免疫球蛋白IgA、IgG、IgM、补体C3、C4以及总蛋白(TP)、清蛋白(ALB)、前清蛋白(PA)水平并进行相关性分析。结果观察组TP、ALB和PA水平均显著低于对照组(P<0.001);观察组IgM、C3水平低于对照组,差异具有统计学意义(分别为P<0.05、P<0.01),而C4水平明显高于对照组(P<0.001);观察组IgM、CD3+与ALB水平呈正相关(分别为r=0.48,P<0.01;r=0.47,P<0.01),IgG、IgM、C3、CD3+、CD4+与PA水平呈正相关(分别为r=0.46,P<0.01;r=0.51,P<0.01;r=0.56,P<0.01;r=0.54,P<0.01;r=0.49,P<0.01);所有免疫学指标与TP无显著相关性。结论尿毒症患者机体营养不良和免疫功能紊乱常常同时存在,而机体免疫功能紊乱和低下与营养不良状况具有显著相关性,机体营养不良是引起免疫功能紊乱的因素之一。

Objective To understand the relationship between immune function and nutritional status in patients with uremia and provide a theoretical basis for further study in immune function.Methods 75 cases of patients with uremia in our hospital from October 2013 to May 2014 were selected as the observation group,at the same time15 healthy were selected as the control group.T cell subsets CD3＋,CD4＋,CD8＋,CD4＋/CD8＋and immunoglobulins IgA,IgG,IgM,complement C3,C4 and total protein,albumin,prealbumin levels were detected in fasting venous blood samples of the two groups and analyzed the correlation of these test items.Results levels of TP,ALB and PA in the observation group were significantly lower than those in the control group（P〈0.001）.levels of IgM,C3 in the observation group were lower than those in the control group（P〈0.05,P〈0.01）,and the difference was statistically significant,but levels of C4 were significantly higher than those in the control group（P〈0.001）.IgM,levels of CD3＋were positively correlated with the levels of ALB in observation group（r=0.48,P〈0.01;r=0.47,P〈0.01）,IgG,IgM,C3,CD3＋,CD4＋were positively correlated with PA（r=0.46,P〈0.01;r=0.51,P〈0.01;r=0.56,P〈0.01;r=0.54,P 0.01;r=0.49,P 0.01）,and all immunology index were no significant correlation with TP.Conclusion Immune function disorder was significantly correlated with malnutrition,so the body′s malnutrition may be the one of the factors causing immune function disorder.