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目的观察终末期肾脏病(ESRD)患者T淋巴细胞亚群的变化及与氧化应激的关联。方法选择住院和门诊ESRD患者40例,其中20例接受血液透析治疗,为Ⅰ组;另20例未接受血液透析治疗,为Ⅱ组;选择同期健康体检者20例为Ⅲ组。检测3组血清超氧化物歧化酶(SOD)、丙二醛(MDA)和T淋巴细胞亚群、凋亡。结果①与Ⅲ组比较,ESRD患者CD3+、CD4+T细胞数及CD4+/CD8+比值均显著下降(P<0.05);而CD3+、CD4+T细胞凋亡率显著升高(P<0.01);两者呈负相关(r=-0.79,P<0.01;r=-0.87,P<0.01)。②与Ⅲ组比较,ESRD患者血清MDA明显升高(P<0.05),SOD明显下降(P<0.05);并且CD3+、CD4+T细胞凋亡率与MDA呈正相关(r=0.41,P<0.05;r=0.58,P<0.01)。结论 ESRD患者T淋巴细胞亚群数量减少与其凋亡率相关,后者又与氧化应激状态关联。因此推测氧化应激可能诱导淋巴细胞过度凋亡,促使细胞数减少,加重ESRD患者免疫功能紊乱。
Objective To observe the changes of T lymphocyte subsets and the relationship with oxidative stress in patients with end-stage renal disease (ESRD). Methods Forty patients with inpatients and outpatients with ESRD were enrolled. Among them, 20 patients were treated with hemodialysis, which were group Ⅰ. The other 20 patients who did not receive hemodialysis were Group Ⅱ. 20 healthy people were selected as group Ⅲ. The levels of serum superoxide dismutase (SOD), malondialdehyde (MDA) and T lymphocyte subsets were detected and the apoptosis was detected. Results ① Compared with group Ⅲ, the numbers of CD3 +, CD4 + T cells and CD4 + / CD8 + in ESRD patients were significantly decreased (P <0.05), while the apoptosis rates of CD3 + and CD4 + T cells were significantly increased (P <0.01) Were negatively correlated (r = -0.79, P <0.01; r = -0.87, P <0.01). ②Compared with the control group, serum MDA significantly increased (P <0.05) and SOD decreased significantly (P <0.05) in ESRD patients, and the positive rates of CD3 + and CD4 + T cells were positively correlated with MDA ; r = 0.58, P <0.01). Conclusion The decrease of T lymphocyte subsets in ESRD patients is related to the apoptosis rate, which is associated with oxidative stress. Therefore speculated that oxidative stress may induce excessive apoptosis of lymphocytes, prompting the reduction of cell number, aggravating immune dysfunction in ESRD patients.