CAPD腹膜炎时白细胞、T细胞亚群及白蛋白之间的相关性  

Correlations among leucocytes,T cell subset and albumin in patients with CAPD-related peritonitis

作　　者：罗琼[1] 熊祖应[1] 聂李平[1] 邵进[1] 熊子波[1] 候霜[1] 郑磊[1] 张帆[1] 梁伟[1] 高敏[1] 

机构地区：[1]北京大学深圳医院肾内科,深圳518036

出　　处：《中国血液净化》2010年第3期126-128,共3页Chinese Journal of Blood Purification

基　　金：深圳市科技局基金(200602023)

摘　　要：目的探讨持续性非卧床腹膜透析(continuous ambulatory peritoneal dialysis,CAPD)患者发生急性腹膜透析相关性腹膜炎时血和腹膜透析液白细胞计数、T淋巴细胞亚群和白蛋白的变化,以及相互之间的关系。方法对2006年1月至2008年3月期间因腹膜透析相关性腹膜炎住院的22例CAPD患者(男12例,女10例,平均62.6岁)进行研究,收集腹膜炎发生后第1、3、6、9、12d的血液和腹膜透析液标本,分别检测血液和腹膜透析液白细胞总数、分类、T淋巴细胞亚群及白蛋白。血T淋巴细胞亚群对照组为同期健康体检人群24例(男13例,女11例,平均60.2岁)。结果与对照组比较,CAPD相关性急性腹膜炎不同时间点血CD3CD8(+)%明显降低,血CD4/CD8明显增高,差异均有统计学意义(P<0.05);血白细胞与腹膜透析液白细胞、血CD4/CD8与腹膜透析液CD4/CD8、腹膜透析液白细胞和腹膜透析液白蛋白均呈正相关(相关系数分别为0.404,0.976,0.434,均P<0.01)。22例患者中腹膜透析液培养阳性17例(77.3%),其中革兰氏阴性杆菌9例(52.9%),革兰氏阳性球菌7例(41.2%),霉菌1例(5.9%)。结论CAPD相关性急性腹膜炎时腹膜透析液白细胞计数和中性粒细胞百分比升高与经腹腔白蛋白丢失增加呈正相关;腹膜炎时血CD4/CD8比值增高,提示患者细胞免疫被激活;革兰氏阴性杆菌已成为我院CAPD相关性腹膜炎的主要致病菌。Objective To investigate the correlations of changes in leucocytes,T cell subset and albumin in peripheral blood and effluent peritoneal dialysate in continuous ambulatory peritoneal dialysis （CAPD） patients complicated with peritonitis.Methods Twenty-two CAPD patients （12 males and 10 females;mean age of 62.6 years old） admitted to the hospital with CAPD-related peritonitis during the period from Jan.2006 to March 2008 were enrolled in this study.Leucocytes,T cell subset and albumin in plasma and effluent dialysate were measured after the presence of peritonitis for 1,3,6,9 and 12 days.T cell subset in blood was also examined in 24 healthy individuals （13 males and 11 females;mean age of 62.6 years old）.Results In patient＇s sera collected at different days after peritonitis,the percentage of CD3CD8（＋） was decreased and the ratio of CD4/CD8 was increased,as compared with those in normal controls （P0.05）.Positive correlations were found between leucocytes in blood and in dialysate （r=0.404,P0.01）,between CD4/CD8 ratio in blood and in dialysate （r=0.976,P0.01）,and between leucocytes and albumin in dialysate （r=0.434,P0.01）.Bacterial culture in dialysate was positive in 17 patients （77.3%）,including Gramnegative bacilli 9 cases （52.9%）,Gram-positive cocci 7 cases （41.2%）,and fungus 1 case （5.9%）.Conclusions In CAPD-related peritonitis,leucocyte increase in dialysate and peritoneal albumin loss were positively correlated,and the increase of blood CD4/CD8 ratio indicated the activated cell-mediated immunity.The main pathogens for CAPDrelated peritonitis were Gram-negative bacilli.

关 键 词：CAPD相关性腹膜炎 白细胞 T细胞亚群 白蛋白 

分 类 号：R459.5[医药卫生—治疗学]