不同营养状态的尿毒症患者血液透析前后免疫功能的变化

Changes of Immune Function in Uremic Patients with Different Nutritional Status before and after Hemodialysis

目的观察不同营养状态下的尿毒症患者血液透析前后免疫功能的变化情况。方法将入选的75例尿毒症患者根据营养状态不同分为A(营养良好)组、B(轻中度营养不良)组、C(重度营养不良)组,并分别于首次透析前、以及透析治疗一个月后采集静脉血液标本,检测T细胞亚群CD3+、CD4+、CD8+和免疫球蛋白IgA、IgG、IgM的水平。结果各组透析后CD3+、CD4+、CD4+/CD8+以及免疫球蛋白水平均较透析前呈上升趋势,透析后与透析前比各组CD3+水平差异明显(P<0.05)、A组IgG与IgM差异明显(P<0.05);各指标在上升幅度上A组与B组和C组比均有统计学差异(P<0.01或P<0.05),B组与C组比除CD3+、IgM差异明显外(P<0.05,P<0.01),其它无统计学差异。结论血液透析可以改善尿毒症患者的免疫功能,良好的营养状态有助于维持性血液透析患者机体免疫功能的提高。

Objective To observe the changes of immune function in uremic patients with different nutritional status before and after hemodialysis.Methods Seventy-five uremic patients were divided into group A（good nutrition）,group B（mild to moderate malnutrition）,group C（severe malnutrition）depending on the nutritional status.The venous blood samples before the first hemodialysis and after one month hemodialysis treatment were collected,and the levels of CD3＋,CD4＋,CD8＋and IgA,IgG,IgM were detected.Results After hemodialysis CD3＋,CD4＋,CD4＋/CD8＋and immunoglobulin levels in each group were increased than before hemodialysis and the difference in CD3＋level was significantly（P〈0.05）.IgG and IgM was significantly different in group A（P〈0.05）.All indexes were significantly increased in group A compared with group B and group C（P〈0.05,P〈0.01）.CD3＋and IgM between group B and group C were significantly different（P〈0.05,P〈0.01）.Conclusion Hemodialysis can improve immune function in patients with uremia,and good nutritional status can help to improve immune function in maintenance hemodialysis patients.