维持血液透析患者血清TNF-α和sTNF-R水平关系的研究  

The relationship between serum TNT-α and sTNF- R level in patients with maintaining hemodialysis

作　　者：金建生[1] 张明[1] 赵朝晖[1] 林庆友[1] 李频 

机构地区：[1]福建医科大学附属协和医院肾内科,福州350001 [2]福建省临床免疫研究所

出　　处：《中国血液净化》2003年第4期186-188,共3页Chinese Journal of Blood Purification

摘　　要：目的 探讨维持血液透析(MHD)加快残余肾功能丧失,促进免疫功能紊乱的机制与MHD患者血清中肿瘤坏死因子和可溶性肿瘤坏死因子受体的相关性。方法 应用酶联免疫方法(ELISA)测定MHD患者透析前、透析后及慢性。肾功能衰竭(CRF)非透析患者与30例正常对照组血清中肿瘤坏死因子(TNF-α)和可溶性肿瘤坏死因子受体(sTNF-R)的水平。结果 CRF患者TNF—α和sTNF-R水平明显高于正常对照组,且MHD组较非透析组增高显著,MHD组透析后TNF—α和sTNF—R水平较透析前亦明显增高,4组间有显著差别(P<0.05);且CRF患者的贫血程度与TNF-α和sTNF-R的水平呈负相关。结论 MHD患者残余肾功能的丧失与TNF—α及其受体水平的增高有相关性,其是否通过促进机体免疫损伤所致尚需进一步研究证实。Objective To investigate the mechanism of maintaining hemodialysis(MHD) to quicken the loss of residual renal function and accelerate the progression of immunologic function disorder as well as the correlation of serum tumor- necrotizing factor (TNF) and soluble TNF receptor (sTNF - R) in MHD patients. Methods With Enzyme -Linked Immunosorbent assay( ELBA) , serum TNF -α and sTNF - R levels were measured in MHD patients before and after dialysis and patients with chronic renal failure(CRF) without dialysis and 30 normal control subjects. Results TNF -α and sTNF - R levels in CRF patients were obviously higher than those in normal control group, with those in MHD group significantly higher than in non - dialytic group. In MHD group, TNF -α and sTNF - R levels were markedly elevated after dialysis ,There are significant differences( P < 0.05) among the four groups , Moreover, the severity of anemia in CRF patients is negatively correlated with TNF -α and sTNF - R levels. Conclusion The elevated levels of TNF -α and its receptor possibly contributes to the loss of residual renal function in the patients treated with MHD, the mechanism of which needs to be further studied.

关 键 词：维持血液透析 血清 TNF—α sTNF—R 残余肾功能 免疫功能紊乱 肿瘤坏死因子 慢性肾功能衰竭 

分 类 号：R692.5[医药卫生—泌尿科学]