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目的评估尿毒症维持性血液透析(MHD)患者近期胸腺输出nave T细胞的情况。方法对郑州大学附属肿瘤医院2010年10月至2011年10月收治的15例MHD患者利用实时定量PCR(TaqMan)方法检测其透析前后外周血单个核细胞中T细胞受体删除DNA环(TRECs)的含量,并根据外周血中CD3阳性率计算CD3+T细胞中TRECs水平。以10例年龄相匹配的正常人外周血作为对照。结果与正常人外周血中TRECs拷贝数相比,15例MHD者首次透析前的TRECs均显著低下,分别为(0.48±0.39)拷贝/1000 PBMCs和(1.03±0.57)拷贝/1000CD3+T细胞(P值分别为0.0014和0.0067)。而透析2～6个月后外周血中的TRECs值差异较大,平均为(0.41±0.36)拷贝/1000 PBMCs和(1.33±1.46)拷贝/1000 CD3+T细胞(P值分别为0.0008和0.019),仍明显低于正常水平,与首次透析前的水平相比,差异无统计学意义。结论 MHD患者首次透析前及透析2～6个月后胸腺近期输出nave T细胞功能均明显低下,胸腺近期输出功能低下是导致细胞免疫功能缺陷的根本原因之一。
Objective To assess recent thymic output of nave T cells in uremic patients with maintenance hemodialysis (MHD). Methods Fifteen patients with MHD admitted to Cancer Hospital of Zhengzhou University from October 2010 to October 2011 were tested for T cell receptor deletion DNA (TRECs) in peripheral blood mononuclear cells by real-time quantitative PCR (TaqMan) The level of TRECs in CD3 + T cells was calculated according to the positive rate of CD3 in peripheral blood. Peripheral blood samples from 10 normal subjects were used as controls. Results The TRECs in the 15 MHD patients were significantly lower than those in the normal controls (0.48 ± 0.39 copies / 1000 PBMCs and (1.03 ± 0.57) copies / 1000 CD3 + T cells, respectively P values were 0.0014 and 0.0067, respectively). However, TRECs in peripheral blood differed significantly after 2 to 6 months of dialysis with an average of (0.41 ± 0.36) copies / 1000 PBMCs and (1.33 ± 1.46) copies / 1000 CD3 + T cells (P values of 0.0008 and 0.019, respectively ), Still significantly lower than the normal level, compared with the level before the first dialysis, the difference was not statistically significant. Conclusion The function of nave T cells in patients with MHD before and after dialysis for 2 ~ 6 months is obviously low, and the short-term output of thymus is one of the underlying causes of cellular immune dysfunction.