血清sCD23在尿毒症维持性血液透析患者中的变化

Changes of serum sCD23 in uremic patients with maintaining hemodialysis

目的 :观察尿毒症维持性血液透析患者应用不同种类透析膜对血清sCD2 3水平的影响 .方法 :采用双抗体夹心ELISA法 ,对尿毒症维持性血液透析患者采用醋酸纤维素膜(CA)、血仿膜 (HE)和聚砜膜 (PS)透析器进行透析 ,分为初用组和复用组检测透析过程中不同透析时间患者血清sCD2 3水平的变化 .结果 :尿毒症维持性血液透析患者首次使用透析器 (初用组 )透析开始后 1 5min时 ,血清sCD2 3水平迅速升高[CA (2 3± 1 1 )U/mL ,HE (1 8± 5 )U/mL ,PS (1 9± 8)U/mL],随着透析的继续进行 ,血清sCD2 3逐渐下降 ,透析结束时 [CA(1 5± 9)U/mL ,HE (1 2± 6 )U/mL ,PS (1 4± 7)U/mL]与透析前 [CA (1 3± 7)U/mL ,HE (1 2± 9)U/mL ,PS (1 2± 6 )U/mL]相比无显著性差异 (P >0 .0 5 ) .不同种类透析膜中 ,CA对血清sCD2 3的影响显著大于HE和PS(P <0 .0 5 ) ;透析器复用(复用组 )对血透患者血清sCD2 3水平无明显影响 .结论 :尿毒症维持性血透患者血透过程中血清sCD2 3水平规律性的变化 ,是导致患者机体免疫力下降的可能原因之一 ,而这些变化与透析膜的生物不相容性有关 ,HE和PS生物相容性优于CA 。

AIM: To observe changes of serum sCD23 levels in uremic patients with maintaining hemodialysis (MHD) using different types of dialyzers. METHODS: The serum levels of sCD23 in uremic patients during hemodialysis were measured by double antibody with ELISA. Three kinds of dialyzers (cellulose acetat, hemophan and polysulfone) were used. The patients were divided into first use and reuse groups. RESULTS: At 15th minute after HD, the levels of sCD23 increased rapidly [CA (23±11) U/mL, HE (18±5) U/mL, PS (19±8) U/mL] in MHD patients firstly using dialyzers. Thereafter, the levels of sCD23 gradually decreased. There was no significant difference in sCD23 levels between initial [CA (13±7) U/mL, HE (12±9) U/mL, PS (12±6) U/mL] and the end of a single session [CA (15±9) U/mL, HE (12±6) U/mL, PS (14±7) U/mL] ( P >0.05). The effect of cellulose acetat dialyzer on sCD23 was significantly different with that of hemophan and polysulfone dialyzers ( P <0.05). The levels of sCD23 were not significantly different between the different kinds of dialyzer in reuse group. CONCLUSION: The regular changes of the levels of sCD23 may lead to decreased immune function in MHD patients, which are associated with the membrane's biocompatibility. The reuse of the dialyzer may ameliorate membrane biocompatibility.