外周血调节性T细胞在尿毒症血液透析前后的变化及临床意义

Changes and clinical significance of regulatory T cells in peripheral blood in uremic patients before and after hemodialysis

目的探讨尿毒症患者血液透析前后外周血调节性T细胞(Treg)及其细胞因子转化生长因子β1(TGF-β1)、白介素10(IL-10)的变化及临床意义。方法选择2014年8月至2016年2月期间我院收治的行血液透析治疗的50例尿毒症患者纳入观察组,50例健康体检者纳入对照组,检测对照组入组次日及观察组透析治疗前、治疗1个月、3个月及6个月时外周血Treg及IL-10、TGF-β1水平,并同时检测肾功能水平。结果观察组治疗前Treg及其细胞因子TGF-β1、IL-10含量分别为(2.08±0.23)%、(1.78±0.21)%、(1.56±0.19)%,均低于对照组的(7.27±1.02)%、(5.28±0.88)%及(4.79±0.75)%,Scr、BUN分别为(998.47±100.38)μmol/L、(32.19±5.22)mmol/L,均高于对照组的(78.56±30.18)μmol/L、(5.53±3.21)mmol/L,差异均有统计学意义(P<0.05);透析治疗后,观察组Treg、TGF-β1、IL-10含量在治疗1个月、3个月、6个月时间点较治疗前逐级上升,差异有统计学意义(P<0.05);但是治疗6个月后Treg、TGF-β1、IL-10含量分别为(3.48±0.35)%、(3.19±0.28)%、(2.89±0.26)%,仍然低于对照组含量,差异均有统计学意义(P<0.05);观察组Scr、BUN在治疗1个月、3个月、6个月时间点较治疗前逐级下降,差异均有统计学意义(P<0.05)。结论尿毒症患者存在免疫功能紊乱,血液透析有助于改善机体的免疫功能。

Objective To investigate the changes and clinical significance of regulatory T cells(Tregs) and IL-10,TGF-β1in peripheral blood in uremic patients before and after hemodialysis.Methods A total of 50 cases of uremic patients,who treated by hemodialysis in our hospital from Aug.2014 to Feb.2016,were chosen as the observation group,and 50 cases of healthy people were included into the control group.The peripheral blood Treg,IL-10,TGF-β1levels and renal function of the control group at the next day,and of the observation group before dialysis,1 month,3months and 6 months after treatment,were detected.Results Before treatment,the Treg and cytokine TGF-β1,IL-10 in the observation group [(2.08 ± 0.23)%,(1.78 ± 0.21)%,(1.56 ± 0.19)%,respectively] were significantly lower than those of the control group [(7.27±1.02)%,(5.28±0.88)%,(4.79±0.75)%,respectively].The Scr and BUN in the observation group [(998.47 ± 100.38) μmol/L,(32.19 ± 5.22) mmol/L] were significantly higher than those of the control group[(78.56±30.18) μmol/L,(5.53±3.21) mmol/L](P<0.05).Compared with before treatment,the Treg,TGF-β1and IL-10 in the observation group at 1 month,3 months,6 months after dialysis treatment were gradually increased,and the difference was statistically significant(P<0.05).But at 6 months,the Treg,TGF-β1,IL-10 [(3.48 ± 0.35)%,(3.19 ± 0.28)%,(2.89±0.26)%,respectively] were still significantly lower than those in the control group(P<0.05).Compared with before treatment,the Scr and BUN in observation group 1 month,3 months,6 months after treatment were progressively decreased(P<0.05).Conclusion The uremic patients has immune function disorder,and hemodialysis is helpful to improve the immune function.