高血压肾病患者淋巴细胞亚群表达与肾功能减退及预后的相关性分析  

Correlation analysis of lymphocyte subsets expression with renal dysfunction and prognosis in patients with hypertensive nephropathy

作　　者：徐晨峰 赵志 刘伟[1] 余枫[1] 吴燕华[1] 郝文科[1] 胡文学[1] XU Chen-feng;ZHAO Zhi;LIU Wei(Department of Nephrology,Guangdong Provincial People's Hospital,Guangzhou Guangdong 510080,China;Shantou University,Shantou Guangdong 515063,China)

机构地区：[1]广东省人民医院肾内科,广东广州510080 [2]汕头大学,广东汕头515063

出　　处：《临床和实验医学杂志》2025年第6期593-597,共5页Journal of Clinical and Experimental Medicine

基　　金：广东省医学科学研究项目(编号:202101367)。

摘　　要：目的探讨高血压肾病(HTN)患者淋巴细胞亚群表达表达与肾功能减退及预后的相关性。方法将2016年1月至2022年7月广东省人民医院收治的189例HTN患者和242单纯高血压患者纳入本次回顾性研究,分别设为HTN组和对照组。用流式细胞仪检测淋巴细胞亚群[CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、自然杀伤(NK)细胞和CD19^(+)T淋巴细胞],用全自动生化分析仪检测肾功能减退指标[血尿素氮、血肌酐,估算肾小球滤过率(eGFR)]。分析淋巴细胞亚群与血尿素氮、血肌酐、eGFR的相关性。患者出院后通过门诊和电话随访统计,29例进展为ESKD,纳入ESKD组,150例未进展成ESKD,纳入NESKD组。采用单因素和多因素Logistic回归分析影响HTN进展为ESKD的因素。结果HTN组的CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、NK细胞和CD19^(+)T淋巴细胞分别为(75.92±4.84)%、(39.86±4.77)%、(30.41±4.56)%、(17.37±3.83)%和(15.42±1.65)%,显著高于对照组[(63.54±5.36)%、(30.69±5.04)%、(24.83±4.40)%、(11.04±3.20)%、(10.04±0.96)%],差异均有统计学意义(P<0.05)。HTN组的血尿素氮和血肌酐分别为(39.98±1.55)mmol/L、(168.75±15.84)μmol/L,显著高于对照组[(19.79±1.39)mmol/L、(30.39±7.31)μmol/L],而eGFR为(63.07±15.33)mL/(min·1.73 m^(2)),显著低于对照组[(122.30±17.04)mL/(min·1.73 m^(2))],差异均有统计学意义(P<0.05)。HTN患者的CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、NK细胞和CD19^(+)T淋巴细胞与血尿素氮、血肌酐呈正相关(P<0.05),与eGFR呈负相关(P<0.05)。ESKD组的年龄、收缩压、舒张压、高血压家族史、HTN病程、血尿素氮、血肌酐高于NESKD组,而CD3^(+)T淋巴细胞、CD4^(+)T淋巴细胞、CD8^(+)T淋巴细胞、NK细胞、CD19^(+)T淋巴细胞、eGFR均低于非ESKD组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析显示,HTN病程是HTN进展为ESKD的危险因素(P<0.05),CD8^(+)T淋Objective To investigate the correlation between the expression of lymphocyte subsets and renal function decline and prognosis in patients with hypertensive nephropathy(HTN).Methods A total of 189 HTN patients and 242 patients with simple hypertension admitted to Guangdong Provincial People's Hospital from January 2016 to July 2022 were selected for this retrospective study and were included in the HTN group and the control group,respectively.Flow cytometry was used to detect lymphocyte subsets[including CD3^(+)T lymphocytes,CD4^(+)T lymphocytes,CD8^(+)T lymphocytes,natural killer(NK)cell,and CD19^(+)T lymphocytes].Automatic biochemical analyzer was used to detect indicators of renal dysfunction[including blood urea nitrogen,serum creatinine,and estimated glomerular filtration rate(eGFR)].The correlation between lymphocyte subsets and BUN,Scr,and eGFR was analyzed.Through outpatient and telephone follow-up statistics after discharge,29 patients progressed to end-stage kidney disease(ESKD)and were included in the ESKD group,and 150 patients did not progress to ESKD and were included in the NESKD group.The factors affecting the progression of HTN to ESKD were analyzed by univariate and multivariate Logistic regression analysis.Results CD3^(+)T lymphocytes,CD4^(+)T lymphocytes,CD8^(+)T lymphocytes,NK ceu,and CD19^(+)T lymphocytes of the HTN group were(75.92±4.84)%,(39.86±4.77)%,(30.41±4.56)%,(17.37±3.83)%,and(15.42±1.65)%,respectively,which were dramatically higher than those in the control group[(63.54±5.36)%,(30.69±5.04)%,(24.83±4.40)%,(11.04±3.20)%,(10.04±0.96%)],the differences were statistically significant(P<0.05).Blood urea nitrogen,serum creatinine in the HTN group were(39.98±1.55)mmol/L and(168.75±15.84)μmol/L,respectively,which were dramatically higher than those in the control group[(19.79±1.39)mmol/L,(30.39±7.31)μmol/L],while eGFR was(63.07±15.33)mL/(min·1.73 m^(2)),which was dramatically lower than that in the control group[(122.30±17.04)mL/(min·1.73 m^(2))],the differences were stat

关 键 词：高血压肾病 淋巴细胞亚群 肾功能减退 预后 相关性 

分 类 号：R544.1[医药卫生—心血管疾病]