血液透析对白细胞粘附分子表达调节的影响  

The effects on the expression of leukocyte adhesion molecules during hemodialysis

作　　者：钱家麒[1,2] 徐筱琪[1,2] 石学耕[1,2] 余志远[1,2] 史桂英[1,2] 

机构地区：[1]上海第二医科大学附属仁济医院肾脏科 [2]上海第二医科大学生物物理教研室

出　　处：《中华肾脏病杂志》1999年第1期5-9,共5页Chinese Journal of Nephrology

基　　金：国家自然科学基金;上海市高等学校科技发展基金

摘　　要：目的探讨血透中粒细胞和单核细胞表面粘附分子表达的变化规律及其对长期透析患者免疫能力下降的可能作用。方法采用流式细胞分析技术检测血透患者粒细胞和单核细胞表面ＣＤ１１ｂ、ＣＤ４５、ＣＤ５４和Ｌｓｅｌｅｃｔｉｎ在透析中的表达水平，并观察了不同的透析膜对其变化的影响；同时测定外周血中上述两种细胞的数量。结果透析开始后，细胞表面ＣＤ１１ｂ的表达迅速上升，而Ｌｓｅｌｅｃｔｉｎ则显著下降，同时伴随外周血细胞计数的减少；铜仿膜组的变化显著大于聚砜膜组。ＣＤ４５的变化与ＣＤ１１ｂ的变化相似；二组患者细胞表面ＣＤ５４在整个透析过程中基本无变化。结论白细胞表面粘附分子在血透中有规律的变化，导致了外周血白细胞减少，同时可能损害了白细胞的正常粘附能力，降低了机体的免疫力；而这些变化与使用的透析膜的生物不相容性有关。Objective To investigate the trends of leukocyte adhesion molecules expression by hemodialysis therapy,and the relationship between these changes with the impaired immunity in longterm hemodialysis patients. Methods The expressions of CD11b,CD45,CD54 and Lselectin on granulocytes and monocytes during dialysis with different dialyzer membranes were assessed by flow cytometry and the cells numbers were counted concomitantly. Results Shortly after hemodialysis the expression of CD11b increased rapidly,while that of Lsclectin decreased and also did the cells numbers.The magnitudes of these changes on CU were larger than those on PS.The overexpression of CD45 was similar to that of CD11b,while there was no significant change in the expression of CD54 during dialysis on either of membrane group.T5HZConclusion The regular changes in the expression of adhesion molecules on leukcoytes not only lead to the leukopenia occuring in a dialysis session,but may also disturb the normal adhesion immune function of leukocytes in dialysis patients.All of these changes are associated with the dialyzer membrane's biocompatibility.

关 键 词：血液透析 透析膜 白细胞粘附分子 生物相容性 

分 类 号：R459.5[医药卫生—治疗学]