规律运动对维持性血液透析患者Th1、Th2和Th17的免疫调节作用  

Immunomodulatory effect of regular exercise on Th1, Th2 and Th17 in maintenance hemodialysis patients

作　　者：邢艳芳[1] 柏明军[2] 秦军建[1] 李星[3] 黄明声[2] Xing Yanfang;Bai Mingjun;Qin Junjian;Li Xing;Huang Mingsheng(Department of Nephrology,the Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, China)

机构地区：[1]广州医科大学附属第三医院肾内科,广州510150 [2]中山大学附属第三医院介入血管科,广州510630 [3]中山大学附属第三医院肿瘤内科,广州510630

出　　处：《新医学》2019年第1期37-42,共6页Journal of New Medicine

基　　金：国家自然科学基金青年科学基金项目(81700645);广州市属高校青年科研项目(1201630019);广州医科大学青年科研项目(2016A09)

摘　　要：目的探讨规律运动对维持性血液透析患者外周血辅助性T细胞1(Th1)、Th2和Th17的影响及临床意义。方法选择60例维持性血液透析患者,分为研究组与对照组各30例,研究组患者进行基于家庭的规律运动计划,持续6个月;对照组未进行运动计划。分别在入组时、入组6个月后采集2组患者的外周血,分离外周血单个核细胞,流式细胞仪分析2组患者外周血中Th1(CD4^+IFN-γ^+)、Th2(CD4^+IL-4^+)和Th17 (CD4^+IL-17^+)的比例,同时记录6个月观察期内2组患者自感用力度指数达12或以上的运动次数及感染情况,比较入组时与入组6个月后的Th1、Th2和Th17比例差异。结果 2组患者均完成6个月的随访,其中研究组患者均完成6个月的规律运动计划。在6个月的观察期内,研究组达到自感用力度指数达12或以上的运动为(13.8±0.5)次/月,对照组则为(8.2±0.3)次/月,组间比较差异有统计学意义(P<0.01)。6个月的观察期内,研究组患者发生感染(0.90±0.16)次/月,对照组则为(1.30±0.17)次/月,组间比较差异亦有统计学意义(t=9.385,P<0.001)。研究组患者Th1比例由入组时的(25.97±8.55)%下降至入组6个月后的(19.83±7.60)%(P<0.05),Th17细胞比例由入组时的(4.09±2.65)%下降至入组6个月后的(2.25±1.23)%(P<0.05),入组时和入组6个月后的Th2比例比较差异无统计学意义(P>0.05)。对照组在入组时和入组6个月后的Th1、Th2、Th17比例比较差异均无统计学意义(P均>0.05)。结论规律运动可以使维持性血液透析患者Th1和Th17细胞水平下调,减少感染的发生,提示规律运动对免疫系统可能有一定的调节作用。Objective To investigate the effect and clinical significance of regular exercise on the peripheral T helper cells(Th1), Th2 and Th17 in the maintenance hemodialysis patients. Methods Sixty maintenance hemodialysis patients were selected and divided into the experimental(n=30) and control groups(n=30). Patients in the experimental group were prescribed with a home-based exercise program for a total duration of 6 months. Patients in the conrtol group were not given with a prescription for exercise program. Peripheral blood samples were taken upon and 6 months after the study enrollment. The mononuclear cells were separated from the peripheral blood. The proportion of Th1(CD4^+IFN-γ^+), Th2(CD4^+IL-4^+) and Th17(CD4^+IL-17^+) cells was quantitatively detected by using flow cytometry. During 6-month observation period, the exercise frequency with a rating of perceived exertion ≥ 12 and the infection status were recorded. The percentage of Th1, Th2 and Th17 upon and 6 months after the enrollment were statistically compared within each group. Results All patients in two groups completed the 6-month follow-up and those in the experimental group finished the 6-month exercise program. During the 6-month observation period, the exercise frequency with a rating of perceived exertion ≥ 12 in the experimental group was(13.8±0.5) times/month, significantly lower than(8.2±0.3) times/month in the control group(P < 0.01). In the experimental group, the infection status was(0.90±0.16) times/month, significantly less than(1.30±0.17) times/month in control group(t=9.385, P < 0.001). In the experimental group, the proportion of Th1 cells upon the enrollment was(25.97±8.55)%, considerably decreased to(19.83±7.60)% at 6 months after the enrollment(P < 0.05) and the percentage of Th17 cells was declined from(4.09±2.65)% to(2.25±1.23)%(P < 0.05), whereas the proportion of Th2 cells did not significantly differ upon and 6 months after the enrollment(P > 0.05). In the control group, the proportion of Th1, Th2 and Th17 cells d

关 键 词：终末期肾病 规律运动 辅助T细胞 

分 类 号：R692.5[医药卫生—泌尿科学]