维持性血液透析合并心力衰竭患者血清调节性T细胞与炎性因子的表达及意义  

Regulatory T Cells and Inflammatory Factors in Patients With Maintenance Hemodialysis Complicated by Heart Failure

作　　者：沈学飞[1] 韩晓云[1] 殷爱民[1] 张良伟[1] 

机构地区：[1]中国人民解放军401医院崂山分院肾内科,山东省青岛市266001

出　　处：《中国全科医学》2012年第23期2702-2703,共2页Chinese General Practice

摘　　要：目的观察维持性血液透析合并心力衰竭(心衰)患者外周血调节性T细胞(Treg)和炎性因子的变化,了解Treg与血液透析患者心衰发生、发展的关系及意义。方法选取16例合并心衰的血液透析患者(血透心衰组)、20例无合并症的血液透析患者(血透普通组)和20例健康人(对照组),采用流式细胞术检测各组外周血中CD4+CD2+5CD1-27来定义其外周血中Treg表达的百分比,同时通过免疫比浊法和酶联免疫吸附法(ELISA)检测各组的血清C-反应蛋白(CRP)、血清白介素-6(IL-6)、IL-10水平。结果血透普通组和血透心衰组的Treg较健康对照组减少,差异均有统计学意义(P<0.05);而两组的血清CRP、IL-6、IL-10水平较对照组均增高,差异有统计学意义(P<0.05)。血透心衰组的Treg及IL-10水平低于血透普通组,血清CRP、IL-6水平高于血透普通组,差异均有统计学意义(P<0.05)。结论血液透析合并心衰患者外周血Treg减少,炎性因子水平增加,改善血透患者的自身免疫功能,可能对改善炎症状态、纠正慢性心衰有积极作用。Objectives To investigate the abnormality and relationship between CD＋4CD＋25CD-127regulatory T cell（Treg） and inflammatory factors in peripheral blood of patients with maintenance hemodialysis complicated by heart failure.Methods Flow cytometry was used to detect the frequencies of CD＋4CD＋25CD-127 regulatory T cells to determine the percentage of Treg expression in peripheral blood and immunoturbidimetry and enzyme linked immunosorbent assay（ELISA） to detect the levels of C-reactive protein（CRP）,serum interleukin-6（IL-6）,IL-10 in 16 patients with hemodialysis complicated by heart dysfuction（HD＋HF group）,20 with hemodialysis（HD group） and 20 normal individuals（control group）.Results Compared with control group,the frequencies of CD＋4CD＋25CD-127 Tregs decreased significantly in groups HD＋HF and HD（P0.05）,and CRP,IL-6,IL-10 increased.Treg and IL-10 were lower in HD＋HF group than in HD group（P0.05）,but CRP,IL-6 higher（P0.05）.Conclusion Treg decreases,inflammatory factors increase in HD＋HF patients.Improving immune function may have a positive effect in correcting inflammatory state and chronic heart failure.

关 键 词：肾透析 心功能不全 T淋巴细胞 调节性 炎性因子 

分 类 号：R459.52[医药卫生—治疗学] R541.6[医药卫生—临床医学]