中国血液净化

›› 2007, Vol. 6 ›› Issue (1): 20-23.

• 论著 • 上一篇    下一篇

血液透析对终末期肾病患者体内IL-13水平的影响

王 俊 严海东 李雪竹 张瑞青 齐华林   

  1. 200120 上海，同济大学附属东方医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-01-12 发布日期:2007-01-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-01-12 Published:2007-01-12

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摘要： 目的 探讨终末期肾病(End stage renal disease ESRD)患者血浆白细胞介素13(Interleukin 13 IL-13)水平以及血液透析(Hemodialysis HD)对其的影响，并判断其能否作为评价透析膜生物相容性的指标。方法 选择同济大学附属东方医院肾内科30例ESRD患者分为未透析组和维持性血液透析(Maintenance hemodialysis MHD)组，MHD组随机分为纤维素生物膜组(650)和聚砜膜组(F6)各10例，同时设立健康正常者10例为对照组。应用酶联免疫吸附(ELISA)法测定MHD患者透析前、后血浆中IL-13水平，以及外周血单个核细胞(Peripherial blood mononuclear cells PBMC)经及未经植物凝集素(Phytohemagglutinin PHA)干预的培养上清中IL-13的水平，同时以半定量逆转录多聚酶链反应(RT-PCR)法检测PBMC中IL-13 mRNA的表达。结果 ESRD未透析组及MHD组透析前血浆IL-13水平较正常对照明显升高,MHD组经透析后血浆IL-13水平下降。ESRD未透析患者的PBMC经PHA刺激后IL-13培养上清水平及mRNA表达量均明显降低，650组PBMC经PHA刺激后IL-13培养上清水平及mRNA表达量无明显变化，F6组PBMC经PHA刺激后IL-13培养上清水平及mRNA表达量明显升高。结论 ①ESRD患者体内处于微炎症状态；②血液透析可改善其炎症状态，从而使IL-13水平下调；③聚砜膜较纤维素生物膜能更好的改善患者的T细胞对抗原的反应能力；④IL-I3可作为评价透析膜生物相容性的指标之一。

关键词: 终末期肾病, 血液透析, 白细胞介素13, 生物相容性

Abstract: Objective To investigate plasma level of interleukin 13 (IL-13) and the effect of hemodialysis (HD) on its expression in patients with end－stage renal disease (ESRD) and to evaluate that if IL-13 can be a biocompatibility index of dialyzer. Methods Thirty patients with ESRD were divided into maintenance hemodialysis (MHD) group and non－hemodialysis group．The plasma level of IL-13 and the level of IL-13 in supernatants of peripheral blood mononuclear cells (PBMC) cultured with or without Phytohemagglutinin (PHA) were measured by enzyme－linked immunosorbent assay (ELISA). The expression of IL-13 mRNA in PBMC were evaluated by reverse transcriptase polymerase chain reaction (RT－PCR). Patients in MHD group was dialyzed with regenerated cellulose membrane (650 group)and polysulphone membrane (F6 group) respectively. Ten healthy persons were as controls(CON group). Results The plasma levels of IL-13 in non-dialysis ESRD patients and MHD patient before dialysis were higher significantly than those of healthy controls. The plasma levels of IL-13 in MHD pationts were decreased after dialysis. The level of IL-13 in supernatants of cultured PBMC and expression of IL-13 mRNA in PBMC in ESRD and non-dialysis patients were decreased with PHA stimulation. They were not obviously changed in 650 group, but further increased significantly in F6 group. Conclusion The microinflammatory state is present in ESRD patients. The level of IL-13 could be decreased through dialysis, so maintanance hemodialysis could improve the microinflammatory state in uraemic patients. Patient's T cell function could be improved by using better biocompatible dialyzers more than poor ones．The IL-I3 could be a parameter in evaluating the biocompatibility of dialyzer．

Key words: Hemodialysis, Interleukin 13, Biocompatibility