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目的观察不同营养状态下的尿毒症患者血液透析前后免疫功能的变化情况。方法将入选的75例尿毒症患者根据营养状态不同分为A(营养良好)组、B(轻中度营养不良)组、C(重度营养不良)组,并分别于首次透析前、以及透析治疗一个月后采集静脉血液标本,检测T细胞亚群CD3+、CD4+、CD8+和免疫球蛋白IgA、IgG、IgM的水平。结果各组透析后CD3+、CD4+、CD4+/CD8+以及免疫球蛋白水平均较透析前呈上升趋势,透析后与透析前比各组CD3+水平差异明显(P<0.05)、A组IgG与IgM差异明显(P<0.05);各指标在上升幅度上A组与B组和C组比均有统计学差异(P<0.01或P<0.05),B组与C组比除CD3+、IgM差异明显外(P<0.05,P<0.01),其它无统计学差异。结论血液透析可以改善尿毒症患者的免疫功能,良好的营养状态有助于维持性血液透析患者机体免疫功能的提高。
Objective To observe the changes of immune function before and after hemodialysis in patients with uremia under different nutritional status. Methods 75 cases of uremic patients were divided into A (nutritionally good) group, B (mild to moderate dystrophy) group, C (severe malnutrition) group according to different nutritional status, and before dialysis, and dialysis treatment Venous blood samples were collected one month later and the level of CD3 +, CD4 +, CD8 + and immunoglobulin IgA, IgG and IgM in T cell subsets were detected. Results The levels of CD3 +, CD4 +, CD4 + / CD8 + and immunoglobulin in the dialysis group were significantly higher than those before dialysis (P <0.05) (P <0.05). There was a significant difference in the increase of each index between A group and B group and C group (P <0.01 or P <0.05), and there was significant difference between B group and C group except CD3 + and IgM P <0.05, P <0.01), the other no significant difference. Conclusion Hemodialysis can improve the immune function of patients with uremia, good nutritional status of patients with maintenance hemodialysis help improve immune function.