中国血液净化

›› 2003, Vol. 2 ›› Issue (5): 240-243.

• 论著 • 上一篇    下一篇

血液透析对转化生长因子β1及补体调节蛋白CD59基因表达的影响

孟建中 李丹丹 彭侃夫 张康丽 徐 悦 肖鹏云 韩翠丽   

  1. 250031 济南，济南军区总医院
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2003-05-19 发布日期:2003-05-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2003-05-19 Published:2003-05-19

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摘要： 目的 研究不同透析膜对维持性血液透析（ MHD） 患者外周血转化生长因子β1及补体调节蛋 白CD59活性表达的影响。方法 通过流式细胞术和酶联免疫吸附方法测定长期采用铜仿膜（CU）和聚砜膜（PSU）透析患者外周血TGF-β1水平和CD59活性表达。结果 MHD患者血浆TGF-β1水平明显增加（ P<0.05）， 其中 CU组为［（2.62±0.18）ng/ml］；PSU组为［（1.19±0.12）ng/ml］，与正常对照组相比均有显著差异（ P<0.01，P<0.05）；而 PSU组与CU组相比，外周血TGF-β1水平明显下降 （P<0.05）。 CD59在正常人外周血单个核细胞中无表达，而在尿毒症未透析组及血液透析组均有表达，其中未透析组表达较低，而血液透析组表达较高，CU膜血液透析组较PSU血液透析组表达要高（ P<0.05）。经相关分析结果显示： CU组与PSU组内TGF-β1水平与CD59表达均呈现良好的相关性（r=0.6409与0.583， P<0.05）。结论 血液透析通过血液-透析膜间相互反应可活化补体，诱导外周血单个核细胞（ PBMC）合成TGF-β1增多，异常增高的TGF-β1水平，则可上调CD59基因表达，抑制补体异常活化造成的细胞破坏，对机体具有代偿性保护意义。然而从生物相容性的角度看，不同透析膜如CU和PSU对MHD患者TGF-β1与CD59的影响有所不同，从细胞因子基因表达水平看，铜仿膜生物相容性较聚砜膜差。

关键词: 血液透析, 转化生长因子β1, 生物相容性炎症, CD59

Abstract: Objective To investigate the effect of different dialysis membranes on perepheral blood transforming growth factor-β1(TGF-β1) and the expression of complement regulatory protein CD59 in maintenance hemodialysis patients(MHD). Methods The levels of perepheral blood TGF-β1 and the expression of CD59 were measured by ELISA assay and flow cytometry in the patients with Cuprophone(CU) and Polysulfone(PSU). Results Compared with the lerels of TGF-β1［(49.3±6.1)ng/ml］in normal control group, the levels of TGF-β1 in MHD patients were significantly increased, but the levels of TGF-β1 in PSU group were significantly tower than that in CU group( P < 0.01). The perepheral blood mononuclear cell of normal person doesn't express CD59, but do in the group of uremia with or without hemodialysis. CD59 activity was lower in the no dialysis group, while higher in the dialysis group,and in CU group was significantly higher than that in PSU group( P<0.05). There is a positive correlation between TGF-β1 levels and CD59 expression both in CU group and PSU group. Conclusion Hemodialysis may activate complement by the reaction of blood and dialysis membrane,which induce the synthesize of TGF-β1 by perepheral blood mononuclear cells while abnormal high level of TGF-β1 would increase the activity of CD59, which inhibit cells damage caused by abnormal complement activation to protect bodies. But different dialysis membrane such as CU and PSU has different effect on TGF-β1 by and CD59 in MHD patients.

Key words: Transforming growth factor-β1, Biocompatibility, CD59