尿毒症患者血液透析前后CD4＋CD25＋CD127lo变化的意义

【目的】探讨透析前后调节性T细胞（Treg）的变化的意义。方法采用三色荧光染色通过流式细胞仪（FCM）分析外周血中CD4＋CD25＋CD127lo细胞水平。结果①血液透析前、后、CKDⅢ-Ⅳ组Treg较正常组显著减少（P〈0.01）;血液透析前后差值,TregP〉0.05;尿素氮（BUN）、血磷（P）,P〈0.01。②根据患者Kt/V、尿素氮下降率〉65%等,将患者分为透析充分与透析不充分组。BuN透析后2组有显著性差异P〈0.01。结论尿毒症毒素可导致Treg不足,Treg参与了尿毒症的发生和发展,透析后并不能改善Treg的不足。

The significance of CD4+CD25+CD1271o regulatory T cell change in uremic patients before and after hemodialysis

Objective To investigate the significance of CD4＋CD25＋CD127lo regulatory T cell（Treg） change in uremic patients before and after hemodialysis.Methods CD4＋CD25＋CD127lo Treg cells in peripheral blood were measured by a flow cytometer.Results（a） In the groups III-IV of chronic kidney disease patients after hemodialysis,the Treg decreased significantly（P 〈 0.01） as compared with that of normal group.The difference of Treg values before and after hemodialysis was significant（P 〈 0.05）,so did the differences of blood urea and serum phosphate（P〈0.01）.（b） Based on the parameters such as Kt/V and decrease of blood urea 〉65%,these patients were divided in to adequate dialysis group and inadequate dialysis group.The difference in blood urea after hemodialysis was significant between the two groups（P 〈 0.01）.Conclusion Treg plays a role in the development of uremia.The uremia toxins may result in the insufficiency of Treg,but the insufficiency can not be reversed by hemodialysis.