中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (02): 77-82.doi: 10.3969/j.issn.1671-4091.2019.02.002

• 临床研究 • 上一篇    下一篇

树突状细胞及炎性因子在血液透析前后的变化分析

胡爽1,余文洪1,彭侃夫1   

  1. 1. 陆军军医大学第一附属医院肾内科
  • 收稿日期:2018-06-28 修回日期:2018-11-26 出版日期:2019-02-12 发布日期:2019-01-25
  • 通讯作者: 彭侃夫 talkmanpeng@sohu.com E-mail:talkmanpeng@sohu.com
  • 基金资助:

    本论文受国家自然科学基金资助（面上项目），基金号81873606

Changes of dendritic cells and inflammatory factors in uremic patients before and after hemodialysis

  • Received:2018-06-28 Revised:2018-11-26 Online:2019-02-12 Published:2019-01-25

PDF

601

摘要： 【摘要】目的探究血液透析患者透析前后树突状细胞及炎性因子水平的变化。方法选取在陆军军医大学第一附属医院肾内科接受3 个月及以上治疗的尿毒症患者22 例作为观察组，另选25 例健康人作为对照组；与对照组相比，观察组患者血液透析前后尿素氮(blood urea nitrogen，BUN)、肌酐(serum creatinine，SCr)、血红蛋白(hemoglobin，Hb)、C 反应蛋白(C-reactive protein，CRP)、白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子(tumor necrosis factor-alpha，TNF-α)及树突状细胞(CD80、CD86、CD83、CD40、IL-12)水平的变化。结果观察组患者治疗前BUN、SCr、Hb、CRP、IL-6 及TNF-α均较对照组显著增加(P 值分别为0.001,＜0.001,＜0.001,＜0.001,＜0.001,＜0.001)，观察组治疗后BUN、SCr、Hb、CRP、IL-6 及TNF-α水平较其治疗前显著降低(P 值分别为0.001,＜0.001,＜0.001,＜0.001,＜0.001,＜0.001)；同时观察组治疗前CD80、CD86、CD83、CD40、IL-12 较对照组明显降低(P 值分别为0.001, 0.001,0.001,0.001,＜0.001)，而观察组治疗后CD80、CD86、CD83、CD40、IL-12 表达率较观察组治疗前显著增加(P 值分别为0.001,0.001,0.001,0.001,0.001)，但仍低于对照组(均P＜0.001)。结论尿毒症患者通过维持性血液透析治疗，使得外周血中成熟树突状细胞较透析前明显增多，这可能有助于患者微炎症状态的改善，带来获益。

关键词: 尿毒症, 血液透析, 微炎症状态, 树突状细胞, 炎性因子

Abstract: 【Abstract】Objective To explore the changes of dendritic cells and inflammatory factors in hemodialysis patients before and after dialysis. Method Twenty- two uremia patients treated in our hospital for ≥3 months were recruited as the observation group, and 25 healthy people were selected as the control group.
Changes of blood urea nitrogen (BUN), serum creatinine (SCr), hemoglobin (Hb), C reactive protein (CRP), interleukin-6 (IL-6), interleukin-10 (IL-10), tumor necrosis factor (TNF) and dendritic cells (CD80+, CD86+, CD83+ , and CD40+ cells) were observed before and after hemodialysis in the patients in observation group. Results In observation group before hemodialysis, BUN, SCr, CRP, IL-6, IL-10 and TNF-α were significantly higher than those of control group (P=0.001, ＜0.001, ＜0.001, ＜0.001, ＜0.001 and＜0.001 respectively); after hemodialysis, CRP, IL-6, IL-10, TNF-α, BUN and SCr were significantly lower than those before hemodialysis (P=0.001, ＜0.001, ＜0.001, ＜0.001, ＜0.001 and ＜0.001 respectively). In observation group before hemodialysis, CD80+ , CD86+ , CD83+ and CD40+ cells and IL-12 were significantly lower than those of control group (P=0.001, 0.001, 0.001, 0.001 and ＜0.001 respectively); after hemodialysis, they became significantly higher than those before hemodialysis (P=0.001, 0.001, 0.001, 0.001 and 0.001 respectively) but
were still lower than those of control group (P<0.001). Conclusion Maintenance hemodialysis can significantly increase the number of mature dendritic cells in the peripheral blood of uremic patients, which may contribute to the improvement of microinflammation and clinical status of the patients.

Key words: Uremia, Hemodialysis,  Microinflammatory, Dendritic cell, Inflammatory factor