胸腺肽α_1对维持性血液透析患者外周血T淋巴细胞亚群、NK细胞及IL-2水平的影响

Impact of thymosin α_1 on cellular immune function and serum IL-2 of patients with maintained hemodialysis

目的探讨使用胸腺肽α_1对糖尿病终末期肾病维持性血液透析(血透)患者外周血T淋巴细胞亚群、自然杀伤(NK)细胞及白细胞介素-2(IL-2)水平的影响。方法选取2011年7月至2015年6月在我院血透中心行规律维持性血透患者71例,使用随机数表法完全随机化分为A组36例和B组35例,A组加用胸腺肽α_1皮下注射,每次1.6 mg,每周2次,共用4周;B组不使用胸腺肽α_1;C组40例为健康体检者。应用流式细胞术分别检测试验第一天和一个月时A、B两组外周血T淋巴细胞亚群、NK细胞水平,同时ELISA法检测其外周血血清IL-2水平。C组各指标则均为第一天检测。结果糖尿病终末期肾病维持性血透患者细胞免疫功能及IL-2水平较正常人显著降低,两组比较差异有统计学意义(P<0.05);A组患者治疗后的外周血CD3^+、CD4^+、CD4^+/CD8^+比值及NK细胞明显高于治疗前[CD3^+(%):(51.51±9.22)vs(72.51±10.22);CD4^+(%):(26.85±4.21)vs(37.15±6.21);CD4+/CD8+:(0.70±0.11)vs(1.63±0.23);NK细胞(%):(26.56±6.82)vs(36.21±5.32)],而CD8+水平明显低于治疗前[(38.24±7.54)%vs(24.26±5.51)%,外周血血清IL-2水平明显升高[(15.83±1.82)pg/m L vs(46.23±1.16)pg/m L],差异均有统计学意义(P<0.05);B组患者治疗前后的T淋巴细胞亚群、NK细胞及血清IL-2水平比较差异均无统计学意义(P>0.05)。结论胸腺肽α_1可提高糖尿病终末期肾病维持性血透患者细胞免疫功能,可能对其感染性疾病的防治有一定临床意义。

Objective To observe the impact of thymosin α1 on cellular immune function and serum IL-2 of patients with maintained hemodialysis. Methods A total of 71 cases of patients with end-stage renal disease, who underwent maintained hemodialysis in our hospital from July 2011 to June 2015, were randomly divided into group A（36cases with 1 cycle of treatment of thymosin α1） and group B（35 cases without treatment of thymosin α1）, and 40 cases of healthy persons were chosen as the group C. Group A appiled thymosin α1（subcutaneous injection, 1.6 mg each time, 2times a week, a total of 4 weeks）, while group B didn’t. Peripheral blood T lymphocyte subsets and NK cells were detected by flow cytometry at the first day and after one month of treatment. Serum IL-2 was identified by ELISA（enzyme linked immune-sorbent assay）. Results The cellular immune function and IL-2 level in patients with maintained hemodialysis were significantly lower than the healthy people（P<0.05）. In group A, Peripheral blood CD3+, CD4+, CD4+/CD8+ratio, NK cells and serum IL-2 of after treatment were significantly higher than before treatment [CD3+（%）:（51.51±9.22） vs（72.51±10.22）, CD4+（%）:（26.85±4.21） vs（37.15±6.21）, CD4+/CD8+ratio:（0.70±0.11） vs（1.63±0.23）,NK cells（%）:（26.56±6.82） vs（36.21±5.32）, IL-2（pg/m L）:（15.83±1.82） vs（46.23±1.16）, P<0.05], while CD8+of after treatment was significantly lower than before treatment [（38.24±7.54）% vs（24.26±5.51）%, P<0.05]. There were no significant changes in T lymphocyte subsets, NK cells and serum IL-2 in group B（P>0.05）. Conclusion Thymosin α1can improve cellular immune function and serum IL-2 level of patients with maintained hemodialysis. So it may has enhance the ability of patient’s resistance to infectious diseases.