血液透析滤过对尿毒症患者中性粒细胞吞噬功能的影响

发布时间：2018-08-08 16:59

【摘要】：目的探讨血液透析滤过(HDF)对尿毒症患者中性粒细胞(PMN)吞噬功能的影响。方法随机法选择尿毒症患者29例作为治疗组。每位患者在维持性血液透析期间均接受1次HDF治疗,观察单次HDF治疗治疗前、后中性粒细胞吞噬率(NPR)、中性粒细胞吞噬指数(NPI)以及实验室指标:血尿素氮(BUN)、血肌酐(SCr)、超敏C反应蛋白(Highsensitivity C-reactive protein,hs-CRP)、β2-微球蛋白(β2-microglobulin,β2-MG)、血钾、血磷的变化。另选择体检健康的志愿者25例作为健康组,测定NPR、NPI,作为评价治疗组这两个指标的参考标准。白色葡萄球菌按比浊管法配备成6xl08/mL浓度。治疗组及健康组的血标本与白色葡萄球菌孵育30 min后,涂片,瑞氏-吉姆萨复合染色法染色,于油镜下计数100个PMN,分别记录吞噬细菌的细胞数和每个PMN吞入的细菌数,按公式计算NPR和NPI。其余项目送至我院检验科检测。数据采用SPSS16.0统计软件处理,符合正态分布计量资料以均数±标准差(?x±s)表示,组间比较采用t检验或Wilcoxon秩和检验,P0.05为差异有统计学意义。结果单次HDF治疗前治疗组NPR和NPI均低于健康组水平,差异有统计学意义(P0.05)。HDF治疗后患者NPR高于健康组水平,差异有统计学意义(P0.05),而NPI比较差异无统计学意义(P0.05)。HDF治疗后患者NPR和NPI均高于治疗前水平,差异有统计学意义(P0.05)。单次HDF治疗后Bun、Scr及β2-MG浓度较治疗前明显下降,差异均有统计学意义(P0.05)。HDF治疗前后hs-CRP浓度比较差异无统计学意义(P0.05)。HDF治疗后血钾、血磷浓度较治疗前下降,差异均有统计学意义(P0.05)。结论尿毒症患者中性粒细胞吞噬功能低于健康组水平。单次血液透析滤过治疗后尿毒症患者中性粒细胞吞噬功能较治疗前改善。
[Abstract]:Objective to investigate the effect of hemodiafiltration (HDF) on phagocytosis of neutrophil (PMN) in uremic patients. Methods 29 patients with uremia were randomly selected as treatment group. Each patient was treated with HDF once during maintenance hemodialysis. Before a single HDF treatment, (NPR), neutrophil phagocytosis index (NPI) and laboratory indexes: serum urea nitrogen (BUN), serum creatinine (SCr), serum (SCr), hypersensitive C-reactive protein (hs-CRP), 尾 2-microglobulin (尾 2-MG), serum potassium and blood phosphorus. In addition, 25 healthy volunteers were selected as the healthy group, NPRP NPI was measured as the reference criteria for evaluating these two indexes in the treatment group. Staphylococcus albicans were equipped with 6xl08/mL concentration according to turbid tube method. After incubating with staphylococcus albus for 30 min, the blood samples of the treatment group and the healthy group were stained with Reich's Gimsa staining, 100 PMNs were counted under the oil microscope, and the number of bacteria swallowed by each PMN was recorded. NPR and NPI were calculated according to the formula. The remaining items are sent to the laboratory of our hospital for examination. The data were processed by SPSS16.0 software, and the data of normal distribution were expressed as mean 卤standard deviation (x 卤s). The difference between groups was statistically significant by using t test or Wilcoxon rank sum test (P 0.05). Results the levels of NPR and NPI in the single HDF group were significantly lower than those in the healthy group before and after the treatment (P0.05). The level of NPR in the patients was higher than that in the healthy group. The difference was statistically significant (P0.05), but the difference of NPI was not statistically significant (P0.05). After HDF treatment, NPR and NPI were higher than those before treatment, the difference was statistically significant (P0.05). After single HDF treatment, the concentrations of SCR and 尾 2-MG decreased significantly (P0.05). There was no significant difference in hs-CRP concentration before and after treatment (P0.05). Conclusion the phagocytic function of neutrophils in uremic patients is lower than that in healthy controls. The phagocytosis of neutrophils in uremic patients after single hemodiafiltration was improved.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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