血液透析患者微量元素与细胞免疫功能的关系(1)
[摘要] 目的 测定血液透析患者的微量元素含量及细胞免疫状态，并评估两者之间的关系。 方法 选取我院收治的维持性血液透析患者60例，并于同期随机选取30例体检健康者作为对照组。采集两组基础资料，并检测外周血微量元素锌、铜、硒和铁浓度及T细胞亚群分布，两组间进行比较，并分析各微量元素与T细胞亚群之间的相关性。 结果 血液透析患者的白蛋白和血红蛋白水平均较低，且血浆锌、铁和硒浓度均比健康人群低，但血浆铜水平上升。CD3+、CD4+T淋巴细胞及CD4+/CD8+也降低(P均<0.05)。CD4+T淋巴细胞与血浆锌、硒、铁浓度呈正相关，CD8+T淋巴细胞与血浆锌、硒浓度也呈正相关，但血浆铜水平与CD4+、CD8+T淋巴细胞均无相关性(P>0.05)。 结论 透析患者存在必需微量元素失衡及T淋巴细胞相关免疫调节明显降低，且两者之间存在一定相关性。
[关键词] 微量元素;血液透析;T淋巴细胞;免疫功能
[中图分类号] R277.5 [文献标识码] B [文章编号] 1673-9701(2020)10-0037-04
[Abstract] Objective To determine the content of trace elements and cellular immune status in hemodialysis patients， and to evaluate the relationship between the two. Methods 60 patients receiving maintenance hemodialysis in our hospital were selected. At the same time， 30 healthy subjects were selected randomly as the control group. The basic data of both groups were collected， and the concentrations of trace elements such as zinc，copper，selenium and iron in peripheral blood and the distribution of T cell subsets were detected. The comparison was made between the two groups， and the correlation between each trace element and the T cell subgroup was analyzed. Results The levels of albumin and hemoglobin were lower in hemodialysis patients， and the concentrations of zinc， iron and selenium in plasma were lower than those in healthy subjects， but plasma copper levels were higher in hemodialysis patients.CD3+， CD4+T lymphocytes， and CD4+/CD8+ lymphocytes were also decreased (all P<0.05). CD4+T lymphocytes were positively correlated with plasma zinc， selenium， and iron concentrations. CD8+T lymphocytes were also positively correlated with plasma zinc and selenium concentrations. However， there was no correlation between plasma copper levels and CD4+ and CD8+ T lymphocytes (P>0.05). Conclusion There is an imbalance of essential trace elements and the T lymphocyte-associated immune regulation is significantly reduced in dialysis patients， and there is a certain correlation between the two.
[Key words] Trace elements; Blood hemodialysis; T lymphocyte; Immune function
終末期肾病血液透析患者，由于透析清除、摄入减少及代谢异常等原因，往往存在必需微量元素缺乏而潜在毒性微量元素过量的现象，部分微量元素的异常与不良预后高度相关，但实际临床上微量元素很少被测量[1]。有证据表明，肾功能衰竭的患者经常缺乏锌和硒，给透析患者补充锌和硒可以带来诸多获益，例如改善免疫功能，促进食欲，降低血管疾病风险和感染等[2]。既往研究也发现，锌、铜、硒和铁这些微量元素的含量可以影响并改变氧化应激的程度[3-4]，但其对患者免疫功能的影响及两者之间的关系尚未明确。目前，在斑秃、儿童哮喘、肠易激综合征等其他疾病中，两者间的关系已得到证实[5-7]。本实验旨在研究血液透析患者体内的必须微量元素(锌、铜、铁和硒)及外周血T淋巴细胞亚群与健康人群的差异，并探讨微量元素与细胞免疫功能之间的关系，现报道如下。, http://www.100md.com(潘翠萍 周参新 黄昊乐)
[关键词] 微量元素;血液透析;T淋巴细胞;免疫功能
[中图分类号] R277.5 [文献标识码] B [文章编号] 1673-9701(2020)10-0037-04
[Abstract] Objective To determine the content of trace elements and cellular immune status in hemodialysis patients， and to evaluate the relationship between the two. Methods 60 patients receiving maintenance hemodialysis in our hospital were selected. At the same time， 30 healthy subjects were selected randomly as the control group. The basic data of both groups were collected， and the concentrations of trace elements such as zinc，copper，selenium and iron in peripheral blood and the distribution of T cell subsets were detected. The comparison was made between the two groups， and the correlation between each trace element and the T cell subgroup was analyzed. Results The levels of albumin and hemoglobin were lower in hemodialysis patients， and the concentrations of zinc， iron and selenium in plasma were lower than those in healthy subjects， but plasma copper levels were higher in hemodialysis patients.CD3+， CD4+T lymphocytes， and CD4+/CD8+ lymphocytes were also decreased (all P<0.05). CD4+T lymphocytes were positively correlated with plasma zinc， selenium， and iron concentrations. CD8+T lymphocytes were also positively correlated with plasma zinc and selenium concentrations. However， there was no correlation between plasma copper levels and CD4+ and CD8+ T lymphocytes (P>0.05). Conclusion There is an imbalance of essential trace elements and the T lymphocyte-associated immune regulation is significantly reduced in dialysis patients， and there is a certain correlation between the two.
[Key words] Trace elements; Blood hemodialysis; T lymphocyte; Immune function
終末期肾病血液透析患者，由于透析清除、摄入减少及代谢异常等原因，往往存在必需微量元素缺乏而潜在毒性微量元素过量的现象，部分微量元素的异常与不良预后高度相关，但实际临床上微量元素很少被测量[1]。有证据表明，肾功能衰竭的患者经常缺乏锌和硒，给透析患者补充锌和硒可以带来诸多获益，例如改善免疫功能，促进食欲，降低血管疾病风险和感染等[2]。既往研究也发现，锌、铜、硒和铁这些微量元素的含量可以影响并改变氧化应激的程度[3-4]，但其对患者免疫功能的影响及两者之间的关系尚未明确。目前，在斑秃、儿童哮喘、肠易激综合征等其他疾病中，两者间的关系已得到证实[5-7]。本实验旨在研究血液透析患者体内的必须微量元素(锌、铜、铁和硒)及外周血T淋巴细胞亚群与健康人群的差异，并探讨微量元素与细胞免疫功能之间的关系，现报道如下。, http://www.100md.com(潘翠萍 周参新 黄昊乐)