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目的 :通过检测慢性肾功能不全患者外周血中CD4+ 淋巴细胞分泌细胞因子的情况 ,探讨Th1/Th2细胞类型与慢性肾功能不全发展的关系。方法 :利用流式细胞分析法对 40例慢性肾功能不全患者和健康志愿者 15例外周血中淋巴细胞的胞内细胞因子 (IFN -γ ,IL -4 )和表面抗原 (CD4+ )进行分析。结果 :慢性肾功能不全患者不同期Th1,Th2数及Th1/Th2值与正常对照组相比 ,差异均有显著意义 (P <0 0 5 )。分泌IFN -γ的CD4+ 淋巴细胞数少于分泌IL -4的CD4+ 细胞数 ,致Th1/Th2比值与正常对照组比较明显下降。但肾功能不同期间Th1,Th2数及Th1/Th2值差异无显著意义。患者Th1/Th2比值与血清BUN和Cr值之间有显著相关 (r分别为 0 5 998,0 4181,P<0 0 5 )。结论 :慢性肾功能不全患者存在Th1弱势。
Objective: To explore the relationship between the Th1 / Th2 cell type and the development of chronic renal insufficiency by detecting the secretion of cytokines by CD4 + lymphocytes in peripheral blood of patients with chronic renal failure. Methods: The levels of intracellular cytokines (IFN-γ, IL-4) and surface antigen (CD4 +) in 15 peripheral blood lymphocytes from 40 patients with chronic renal failure and healthy volunteers were analyzed by flow cytometry. Results: There were significant differences in Th1, Th2 and Th1 / Th2 values between patients with chronic renal insufficiency and normal controls (P <0.05). The number of CD4 + lymphocytes secreting IFN-γ was less than the number of CD4 + secreting IL-4, resulting in a marked decrease of Th1 / Th2 ratio compared with that of the normal control group. However, there was no significant difference in Th1, Th2 and Th1 / Th2 between different periods of renal function. There was a significant correlation between Th1 / Th2 ratio and serum BUN and Cr values (r = 0 598, 0 4181, P <0 05, respectively). Conclusions: Th1 deficiency exists in patients with chronic renal insufficiency.