慢性肾衰血、尿SIL-2R的变化及意义  

Change of Soluble Interleukin-2 Receptor and Its Significance in Patients with Chronic Renal Failure

作　　者：单剑萍[1] 马济民[1] 宁琳[1] 薛文清[1] 沈立松[2] 万建伟[2] 

机构地区：[1]上海第二医科大学附属新华医院肾内科,200092 [2]上海第二医科大学附属新华医院检验科

出　　处：《上海第二医科大学学报》1997年第3期191-194,共4页Acta Universitatis Medicinalis Secondae Shanghai

摘　　要：为探讨慢性肾衰（CRF）患者可溶性白介素－2受体（SIL－2R）变化的意义，采用ELISA法检测32例CRF患者的血、尿SIL－2R。根据Ccr分为两组：组ICcr＜10ml／min（n＝23）和组ⅡCcr＞10ml／min（n＝9）。组Ⅰ中透析达6～8周者为组Ia（n＝10），透析已＞8周者为组Ib（n＝5）。结果：1．组Ⅰ患者血SIL－2R明显高于健康对照组（P＜0．01）和组Ⅱ（P＜0．01），而尿SIL－2R无此差异。2．Ia组患者血SIL－2R透析后较透析前明显降低（P＜0．01），但组Ib无此差异。3．组Ia和Ib患者尿SIL－2R浓度在透析前后无统计学差异。4．25例CRF患者外周血CD3（％）和CD4（％）明显降低（P＜0．01），而CD8（％）趋于增高（P＜0．01）。5．血SIL－2R浓度与Ccr呈负相关，与BUN及24h尿蛋白排出量（24hUprV）呈正相关。提示：SIL－2水平可作为免疫系统活化、肌酐清除减少及有效透析的指标之一。Serum and urine soluble interleukin-2 receptor (SIL-2R) levels were determined using the ELISA method in 32 cases of chronic renal failure (CRF) in order to investigate the significance of the change of SIL-2R levels. According to Ccr levels 32 patients with CRF were divided into 2 groups: Ccr<10ml/min (Croup I, n=23) and Ccr>10ml/min (Group Ⅱ, n=9). Group Ⅰwas subdivided into 2 subgroups: Ia (the duration of dialysis was 6- 8 weeks including 8 patients with hemodialysis and 2 cases with intermediate peritoneal dialysis) and Ib (the duration of dailysis was>8weeks) in 5 patients with hemodialysis). The results showed that: 1. serum soluble IL-2Rconcentration in Group Ⅰ cases was significantly higher than those in both healthy controls and the Group Ⅱ cases (P<0.01), but no significant difference in urine soluble IL-2R levels was found;2.after dialysis the serum soluble IL- 2R levels in the subgroup Ia were markedly higher than those in predialysis (P<0.01) but not significantly different from subgroup Ib; 3. before dialysis and after dialysis the difference of the urine soluble IL - 2R concentrations in the subgroup Ia and Ib cases was not found; 4. in 25 patients with CRF it was found that CD3(%) and CD4(%) were markedly reduced;the CD8(%) tend to be increased compared with that of control group (P<0.01); 5. the serum soluble Ⅱ-2R levels were negatively correlated with Ccr and positively correlated with both BUN and 24h UprV. Thus, we suggest that elevated serum soluble IL-2R in CRF is induced by the activation of T cells and may be due to decreased excretion from the kidney. Serum SIL- 2R levels may be an index for immune system activation, decreased creatinine clearance and effecient dialysis.

关 键 词：慢性 肾功能衰竭 T淋巴细胞亚群 白细胞介素2 

分 类 号：R692.502[医药卫生—泌尿科学]