Dynamic change and clinical significance of CD4 + CD25 + regulatory T cell for uremiapatients undergoing hemodialysis
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摘要:
目的探讨调节性T细胞（Treg）及其细胞因子在尿毒症血透患者的动态变化与临床意义 方法收集初诊尿毒症及维持血液透析患者各80例，对以上患者连续3次透析，采用流式细胞术检测外周血Treg及胞内转化生长因子β1（TGF-β1）及白介素10（IL-10）百分含量；并比较透析前后肾功能变化；将Treg、TGF-β1及IL-10与肾功能及临床指标进行相关性分析。 结果健康对照组的Treg、TGF-β1及IL-10百分含量分别为4.27±1.29、2.89±0.93及3.76±1.13，显著高于初诊组及维持透析组（P<0.05）。在3次透析中，初诊患者的Treg、TGF-β1及IL-10均显著低于维持组（P<0.05）；随着透析的进展，两组患者的Treg、TGF-β1及IL-10均明显下降（P<0.05），且下降幅度均以初诊组较维持组大（P<0.05）。初诊组BUN及Scr均显著高于维持组（P<0.05）。随着透析的进展，两组患者的BUN及Scr均明显下降（P<0.05），且下降幅度均以初诊组较维持组大（P<0.05）。初诊尿毒症患者肾功能恢复正常所需时间及住院时间分别为14.16±5.16 及11.39±6.84 d，显著短于维持透析组的18.29±7.72 及15.69±8.39 d（P<0.05）。相关性分析提示Treg、TGF-β1 及IL-10 三者均与BUN、Scr、肾功能恢复正常所需天数及住院天数均呈显著负相关性（P<0.05）。 结论尿毒症患者Treg、TGF-β1及IL-10显著下降，随着透析的进展三者可进行性下降，与肾功能及临床指标密切相关。 Abstract:Objective To study the dynamic change and clinical significance of CD4+CD25+ 的CD4+CD25+regulatory T cell for uremia patients undergoing hemodialysis. Methods To collect original uremia and maintain all the 80 cases of hemodialysis patients, for more than three consecutive patients with dialysis, using flow cytometry test peripheral blood Treg and intracellular transforming growth factor beta 1 (TGF-beta 1) and interleukin 10 (IL-10) percentage; And compare the renal function changes before and after dialysis; Will Treg, TGF-beta 1 and IL-10 and renal function and clinical indicators for correlation analysis. Results The Treg healthy controls, TGF - beta 1 and IL-10 percentage were 4.27 +/-1.29, 2.89 and 3.76 1.13 mm, 0.93 mm was significantly higher than group and maintaining dialysis group (P<0.05). Was in dialysis three times, the Treg, TGF-beta 1 and IL-10 were significantly lower than maintaining group (P<0.05); With the progress of the dialysis, two groups of patients of Treg, TGF - beta 1 and IL - 10 were significantly decreased (P<0.05), and a decline in both the group is to maintain large group (P<0.05). BUN and Scr primary-care group were significantly higher than maintaining group (P<0.05). With the progress of the dialysis, the BUN and Scr in two groups of patients were significantly decreased (P<0.05), and a decline in both the group is to maintain large group (P<0.05). Time needed for both the uremia patients renal function back to normal and hospital stay were 14.16+/-5.16 and 11.39+/-6.84 days, significantly shorter than maintaining dialysis group 18.29 +/-7.72 and 15.69+ /-8.39 days (P<0.05). Correlation analysis suggests Treg and TGF-beta 1 and IL-10 and BUN, Scr and renal function back to normal the required number of days and hospitalization days were significantly negatively correlated (P<0.05). Conclusion The patients with uremia Treg, TGF-beta 1 and IL-10 declined significantly, with the progress of the dialysis three progressive decline, is closely related to renal function and clinical indicators. -
Key words:
- Chronic renal failure /
- Dialysis /
- Regulatory T cells /
- cytokines
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表 1 不同透析次数下的Treg含量比较(x±s，n=80)
分组 Treg（%） F P 第1 次 第2 次 第3 次 初诊组 1.36±0.59# 1.97±0.75* 2.34±0.89*# -2.513 0.025 维持组 2.58±0.93# 2.79±0.98* 3.08±1.07*# -2.306 0.032 t -2.912 -2.371 -2.529 P 0.016 0.031 0.023 与第1 次透析比较,*P<0.05; 与第2 次透析比较,#P<0.05. 
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表 2 不同透析次数下的TGF-β1 含量比较(x±s，n=80)
分组 TGF-β1（%） F P 第1 次 第2 次 第3 次 初诊组 0.93±0.29# 1.12±0.45* 1.79±0.67*# -2.325 0.029 维持组 1.26±0.45# 1.69±0.54* 2.37±0.84*# -2.221 0.037 t -2.161 -2.472 -2.583 P 0.036 0.021 0.018 与第1 次透析比较,*P<0.05; 与第2 次透析比较,#P<0.05.
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表 3 不同透析次数下的IL-10 含量比较(x±s，n=80)
分组 IL-10（%） F P 第1 次 第2 次 第3 次 初诊组 1.16±0.41# 1.72±0.53* 2.13±0.74*# -2.428 0.027 维持组 2.05±0.63# 2.56±0.84* 2.89±0.92*# -2.273 0.034 t -2.482 -2.301 -2.413 P 0.021 0.035 0.029 与第1 次透析比较,*P<0.05; 与第2 次透析比较,#P<0.05.
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表 4 不同透析次数下的BUN含量比较(x±s，n=80)
分组 BUN(mmol/L) F P 第1 次 第2 次 第3 次 初诊组 13.26±4.38 9.16±3.52 5.47±1.86 -5.728 0.013 维持组 11.29±3.26 7.62±3.31 4.17±1.24 -4.391 0.019 t 2.827 2.613 1.912 P 0.032 0.035 0.041
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表 5 不同透析次数下的Scr 含量比较(x±s，n=80)
分组 Scr (μmol/L) F P 第1 次 第2 次 第3 次 初诊组 1104.31±106.72 906.27±99.32 686.45±62.33 103.916 0.000 维持组 825.29±79.16 617.34±58.83 506.84±43.27 78.283 0.000 t 96.717 87.384 56.145 P 0.0000 0.0000 0.002
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