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目的了解尿毒症患者淋巴细胞亚群的改变。方法采用血液细胞计数仪对血液细胞进行分类与计数;使用单激光三色流式细胞仪,分析带荧光标记单克隆抗体染色的淋巴细胞及其亚群。结果①血常规计数表明:尿毒症患者存在淋巴细胞减少症(P<0.005),中性粒细胞百分比高于正常对照组(P<0.005);②淋巴细胞亚群分析提示:尿毒症患者CD3+、CD4+、CD8+细胞百分数以及CD4/CD8比值,与正常对照组相比差异无显著性(P>0.05);NK细胞百分数明显增高(P<0.005),透析组CD8+细胞数较未透析组增加[(27.45±7.26)%Vs(20.33±7.01)%,P=0.042],单核细胞数高于正常对照组[(75.6±9.68)%Vs(63.98±12.82)%P=0.039];B淋巴细胞数低于正常对照组[(4.33±1.69)%Vs(9.49±3.30)%P=0.001];③尿毒症患者表现为Th2细胞优势(P<0.05),Th1/Th2比值显著降低(P<0.05),长期透析后上述表现无改善。结论尿毒症患者T细胞亚群表现为Th2优势,透析患者存在B淋巴细胞减少,淋巴细胞亚群的这些改变可能参与了血液透析患者免疫功能下降的发病机理。
Objective To understand the changes of lymphocyte subsets in patients with uremia. Methods The blood cells were classified and counted by the blood cell counter. The lymphocytes stained with fluorescent labeled monoclonal antibodies and their subgroups were analyzed by single laser three-color flow cytometry. Results ① The blood count showed that the patients with uremia had lymphopenia (P <0.005) and the percentage of neutrophils was higher than that of the normal control group (P <0.005). ② The analysis of lymphocyte subsets suggested that CD3 + The percentage of CD4 +, CD8 + cells and the ratio of CD4 / CD8 in the dialysis group were significantly higher than those in the control group (P> 0.05). The percentage of NK cells was significantly increased (P <0.005) 27.45 ± 7.26)% Vs (20.33 ± 7.01)%, P = 0.042]. The number of monocytes was significantly higher than that of the control group [(75.6 ± 9.68)% vs 63.98 ± 12.82% (4.33 ± 1.69)% Vs (9.49 ± 3.30)% P = 0.001]. ③The uremia patients showed the advantage of Th2 cells (P <0.05), and the Th1 / Th2 ratio was significantly lower than that of the control group (P <0.05) , After long-term dialysis no improvement in the above performance. Conclusions T lymphocyte subsets in patients with uremia manifest Th2 predominance. There is a decrease in B lymphocytes in dialysis patients. These changes in lymphocyte subsets may be involved in the pathogenesis of decreased immune function in hemodialysis patients.