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目的:研究终末期肾病(ESRD)患者Th1/Th2型细胞因子的特征及其与外周血T细胞凋亡的关系,并探讨不同透析膜对T细胞凋亡的影响。方法:应用流式细胞术检测10例ESRD未透析(ND)患者,维持性血液透析的患者45例,分别采用醋酸纤维素膜(CA)、低通聚砜膜(PS-LF)、高通聚砜膜(PS-HF)进行透析,以及8例健康对照组(HC)的外周血T细胞,经PHA刺激培养24h后锚定蛋白(AnnexinV)的表达。用ELISA法检测细胞培养上清IFN-γ及IL-4的水平。结果:ESRD患者未透析组及3种膜透析组T细胞AnnexinV的表达高于健康对照组(P<0.05)。各透析组患者T细胞AnnexinV的表达以CA组最高,PS-HF组最低,组间比较具有统计学意义(P<0.05);ESRD患者各组IFN-γ的水平均低于健康对照组(P<0.05),与AnnexinV的表达呈负相关;IL-4的水平高于健康对照组(P<0.05),与AnnexinV的表达呈正相关。结论:ESRD患者存在Th型细胞因子的失衡,呈Th2型细胞因子占优势,T细胞的凋亡增加。
Objective: To investigate the characteristics of Th1 / Th2 type cytokines in peripheral blood and the relationship with T cell apoptosis in patients with end-stage renal disease (ESRD) and to explore the effect of different dialysis membranes on T cell apoptosis. Methods: Ten cases of non-dialysis (ND) patients with ESRD and 45 cases of maintenance hemodialysis were examined by flow cytometry (FCM), respectively. The contents of cellulose acetate (CA), low- (PS-HF) dialysis, and 8 healthy control (HC) peripheral blood T cells were cultured with PHA for 24 hours after the expression of the anchored protein (AnnexinV). The levels of IFN-γ and IL-4 in cell culture supernatants were detected by ELISA. Results: The expression of Annexin V in T-cell in ESRD patients without dialysis group and in 3 membrane dialysis group was higher than that in healthy control group (P <0.05). The expression of Annexin V of T cells in each dialysis group was the highest in CA group and the lowest in PS-HF group (P <0.05). The levels of IFN-γ in ESRD patients were lower than those in healthy controls <0.05), which was negatively correlated with the expression of AnnexinV. The level of IL-4 was significantly higher than that of healthy controls (P <0.05), which was positively correlated with the expression of AnnexinV. Conclusion: There is an imbalance of Th-type cytokines in patients with ESRD. Th2-type cytokines predominate and T-cell apoptosis increases.