CAJ | 학술논문

目的：探讨了血液透析对终末期肾病合并HBV病毒感染患者免疫功能的影响。方法：随机选取2011年6月至2013年6月期间我院接收救治的50例终末期肾病合并HBV病毒感染患者作为观察组，给予持续性血液透析治疗，同时选取50例单纯终末期肾病患者作为对照组，与观察组给予相同的持续性血液透析治疗方案。分别对两组患者治疗前后24 h尿蛋白量、血清白蛋白、尿素氮、肌酐进行分析；采用流式细胞术分析两组患者治疗前后外周血调节性T淋巴细胞比例和CD8＋T淋巴细胞比例变化，同时对穿孔素／颗粒酶B进行分析。结果：经过透析治疗后，两组患者临床症状及实验室指标均较治疗前有显著性改善，差异具有统计学意义（P＜0.05）。两组治疗后临床症状和实验室指标比较无统计学意义（P＞0.05）。对照组患者治疗后免疫功能与治疗前相比，无明显改变（ P＞0.05）；观察组患者治疗前调节性T淋巴细胞（ Treg细胞）比例和CD8＋T淋巴细胞比例与对照组相比呈显著性升高趋势（ P＜0.05）；治疗前观察组患者外周血中T细胞活化分子穿孔素／颗粒酶B表达率较对照组高（ P＜0.05），经过治疗后，Treg细胞和CD8＋T淋巴细胞比例均显著下降（ P＜0.05），穿孔素／颗粒酶B表达率呈显著下降趋势（ P＜0.05）。结论：血液透析能够显著改善合并HBV病毒感染患者的免疫功能。
목적：탐토료혈액투석대종말기신병합병HBV병독감염환자면역공능적영향。방법：수궤선취2011년6월지2013년6월기간아원접수구치적50례종말기신병합병HBV병독감염환자작위관찰조，급여지속성혈액투석치료，동시선취50례단순종말기신병환자작위대조조，여관찰조급여상동적지속성혈액투석치료방안。분별대량조환자치료전후24 h뇨단백량、혈청백단백、뇨소담、기항진행분석；채용류식세포술분석량조환자치료전후외주혈조절성T림파세포비례화CD8＋T림파세포비례변화，동시대천공소／과립매B진행분석。결과：경과투석치료후，량조환자림상증상급실험실지표균교치료전유현저성개선，차이구유통계학의의（P＜0.05）。량조치료후림상증상화실험실지표비교무통계학의의（P＞0.05）。대조조환자치료후면역공능여치료전상비，무명현개변（ P＞0.05）；관찰조환자치료전조절성T림파세포（ Treg세포）비례화CD8＋T림파세포비례여대조조상비정현저성승고추세（ P＜0.05）；치료전관찰조환자외주혈중T세포활화분자천공소／과립매B표체솔교대조조고（ P＜0.05），경과치료후，Treg세포화CD8＋T림파세포비례균현저하강（ P＜0.05），천공소／과립매B표체솔정현저하강추세（ P＜0.05）。결론：혈액투석능구현저개선합병HBV병독감염환자적면역공능。
Objective:To investigate the effects of hemodialysis f on immune function of patients with end-stage nephropathy associated HBV virus infection.Methods:50 cases of patients with end-stage nephropathy associated HBV virus infection from June 2011 to June 2013 were randomly selected as observation group.50 cases of patients with end-stage renal disease as the control group.Patients in control group and observation group were treated with continuous hemodialysis therapy .24 h urinary protein ,serum al-bumin,blood urea nitrogen and creatinine in control group and observation group before and after treatment were analyzed .The regulatory T lymphocyte ,the CD8+T lymphocytes,perforin and granzyme B in peripheral blood in control group and observation group before and after treatment were analyzed by flow cytometry.Results:After dialysis treatment ,clinical symptoms and laboratory indexes of the two groups were significantly improved ( P<0.05 ).Clinical symptoms and laboratory indexes in control group and observation group after treatment had no statistical difference ( P>0.05 ).There was no significant change of immune function in the control group before and after treatment ( P>0.05 ).But the ratio of Treg cells and CD 8+T lymphocyte in observation group after treatment were sig-nificantly increased than that of before treatment ( P<0.05 ).Before treatment ,the active molecule perforin and granzyme B expression rate of T cells in the peripheral blood of observation group were higher than the control group ( P<0.05 ).After treatment ,Treg cell and CD8+T lymphocyte ratio were significantly decreased as well as perforin and granzyme B expression rate ( P<0.05 ).Conclusion:Compared with control group ,hemodialysis can significantly improve the immune function of the patients with end -stage nephropathy as-sociated HBV virus infection.