血液透析患者血浆PGE_2含量与T细胞亚群和NK细胞活性的关系

Influence of hemodialysis on peripheral Mood prostaglandin E2(PGE2)、NK cell and T cell subsets in uremia petients

目的 探讨血液透析患者外周血前列腺素E2(PGE2)含量与T细胞亚群和NK细胞活性的关系。方法 应用流式细胞仪和酶联免疫分析法检测透析、未透析和长期维持性透析(透析时间大于7年)患者外周血PGE2、T细胞表面CD3、及其亚群CD4及CD8抗原表达。结果 尿毒症未透析组(NHD组)的外周血NK细胞和T细胞的CD3+、CD4+、CD8+表达及CD4+/CD8+比值均显著低于正常对照组(P<0.05);PGE2含量明显增高,并与CD4+/CD8+细胞比值和NK细胞活性间呈负相关。透析后,尿毒症患者PGE2水平降低,CD3+、CD4+和CD8+值及CD4/+CD8+比值均显著上升(P<0.05),NK细胞活性接近于正常对照组。然而透析时间大于7年的尿毒症患者血浆PGE2水平又显著增高,外周血淋巴细胞数值、CD3+细胞浓度、CD4+/CD8+细胞比值及NK细胞活性均显著低于正常组(P均<0.05)。结论PGE2异常增高与细胞免疫功能失衡有关,血液透析能够降低PGE2浓度,改善患者的免疫功能。但长期维持性透析患者免疫功能又呈现恶化状态。

Objectives To investigate the influence of hemodialysis on Peripheral blood ProstaglandinE2(PGE2)、NK cell and T cell subsets in uremia patients. Methods The levels of peripheral blood PGE2 and the expression of antigen on peripheral blood T cells、NK cell from 38 cases of MHD patients and 15 non - hemodialysis(NHD) patients were evaluated by enzyme immunoassay analysis and flow cytometry. Fifteen volunteers were also examined as normal controls. Results Compared with normal control group of PGE2, the levels of PGE2 in NHD patients were significantly increased.The expression of CD3+ , CD4+ 、CD8+ and CD4+CD8 + ratio in NHD was significantly lowered (P < 0.05);In controls with MHD group,the expression of NK cell and CD3 + , CD4+ , CD8 + , CD4+ /CD8 + ratio in MHD group were significantly increased( P < 0.05), and the action of NK cells almost reached to normal. There is a minus correlation between the levels of PGE2 and the expression of CD3 + , CD4 + , CD4+ /CD8 + in NHD group and MHD group. Conclusions The immune function of T cell subgroups was unbalanced under the condition of uremia,the higher concentration of PGE2 may suppress the activation of NK cell, the expression of CD3+ , CD4+ , CD8+ CD4 + /CD8+ ratio. Hemodialysis can decrease the higher concentration of PGE2 and improve the immune function on uremia patients, but take again depravation on the immune function in patients with chronic hemodialysis (MHD>7years).