甲状旁腺激素对维持性血液透析患者调节性T细胞和微炎症的影响  

Effect of parathyroid hormone on regulatory T cells and inflammatory in maintenance hemodialysis patients

作　　者：魏娜[1] 沈学飞[2] 常万松[1] 薛迪中[1] 庄红丽[1] 

机构地区：[1]中国人民武装警察部队河南总队医院心肾科,郑州市450052 [2]中国人民解放军401医院崂山分院,山东青岛266001

出　　处：《医药论坛杂志》2013年第2期29-30,33,共3页Journal of Medical Forum

摘　　要：目的观察甲状旁腺激素(PTH)对维持性血液透析患者外周血调节性T细胞(Treg)和微炎症的影响。方法选取27例合并甲状腺旁腺功能亢进的血液透析患者(高PTH组)、18例无甲状腺旁腺功能亢进的血液透析患者(低PTH组)和20名健康人,采用流式细胞术检测各组外周血中CD4+、CD25+、CD127-来定义其外周血中Treg细胞表达的百分比,同时通过免疫比浊法和酶联免疫吸附法(ELISA)检测各组血清C-反应蛋白(CRP)、血清白细胞介素-6(IL-6)、肿瘤坏死因子-a(TNF-a)。结果两组血液透析患者的Treg细胞较健康对照组明显减少(P<0.05),而两组的CRP,IL-6,TNF-a均显著增高(P<0.05);血液透析伴高PTH组的Treg细胞显著低于低PTH组(P<0.05),而其CRP,IL-6,TNF-a水平显著高于低PTH组(P<0.05)。结论高PTH可抑制T细胞分化,减少Treg产生,促使炎症因子增高。积极清除PTH,可能对改善血液透析患者免疫功能有益。Objective To investigate the effect of parathyroid hormone on CD4＋ , CD25 ＋ , CD127 - regulatory T cell （Treg） and inflammatory factors in maintenance hemodialysis patients. Methods Flow cytometry was used to detect the frequencies of CD4 ＋,CD25 ＋ ,CD127 -regulatory T cells in peripheral blood from 27 hemodialysis patients with high PTH level（ 〉 300 ng/L）, 18 hemodialysis patients with low PTH level（ 〈 300 ng/L） , and 20 normal individuals. Mean- while,the serum CRP, IL - 6 and TNF - a were detected by immunoturbidimetry and ELISA respectively. Results Compared to controls, the frequencies of CIM ＋ , CD25 ＋ , CD127- Tregs in peripheral blood of HD groups were signifi- candy decreased （all P 〈 0. 05 ）. While the CRP, IL- 6 ,TNF -α were obviously raised in both groups. The tregs in the high PTH group were much lower than that in the low PTH group （ P 〈 0. 05 ）, and the CRP, IL - 6, TNF - α increased significantly. （P 〈 0. 05 ）. Conclusions T cell differentiation can be suppressed by high leve PTH, which may de- crease of Tregs and increase inflammatory factors in hemodialysis patients. To remove more PTH may be useful to im- prove the immune function in hemodialysis patients.

关 键 词：甲状旁腺激素 血液透析 调节性T细胞 微炎症 

分 类 号：R692.5[医药卫生—泌尿科学]