目的 观察维持性血液透析合并心力衰竭(心衰)患者外周血调节性T细胞(Treg)和炎性因子的变化,了解Treg与血液透析患者心衰发生、发展的关系及意义.方法 选取16例合并心衰的血液透析患者(血透心衰组)、20例无合并症的血液透析患者(血透普通组)和20例健康人(对照组),采用流式细胞术检测各组外周血中CD+4CD+25CD-127 来定义其外周血中Treg表达的百分比,同时通过免疫比浊法和酶联免疫吸附法(ELISA)检测各组的血清C-反应蛋白(CRP)、血清白介素-6(IL-6)、IL-10水平.结果 血透普通组和血透心衰组的Treg较健康对照组减少,差异均有统计学意义(P＜0.05);而两组的血清CRP、IL-6、IL-10水平较对照组均增高,差异有统计学意义(P＜0.05).血透心衰组的Treg及IL-10水平低于血透普通组,血清CRP、IL-6水平高于血透普通组,差异均有统计学意义(P＜0.05).结论 血液透析合并心衰患者外周血Treg减少,炎性因子水平增加,改善血透患者的自身免疫功能,可能对改善炎症状态、纠正慢性心衰有积极作用.%Objectives To investigate the abnormality and relationship between CD4+CD25 CD,27 regulatory T cell ( Treg ) and inflammatory factors in peripheral blood of patients with maintenance hemodialysis complicated by heart failure. Methods Flow cytometry was used to detect the frequencies of CD4+CD25+CDI27- regulatory T cells to determine the percentage of Treg expression in peripheral blood and immunoturbidimetry and enzyme linked immunosorbent assay ( ELISA ) to detect the levels of C -reactive protein ( CRP), serum interleukin -6 ( IL -6 ), IL - 10 in 16 patients with hemodialysis complicated by heart dysfuction ( HD + HF group ), 20 with hemodialysis ( HD group ) and 20 normal individuals ( control group ). Results Compared with control group, the frequencies of CD4+CD25+CDI27- Tregs decreased significantly in groups HD + HF and HD ( P < 0. 05 ), and CRP, IL - 6, IL - 10 increased. Treg and IL - 10 were lower in HD + HF group than in HD group ( P < 0. 05 ), but CRP, IL -6 higher ( P <0. 05 ). Conclusion Treg decreases, inflammatory factors increase in HD + HF patients. Improving immune function may have a positive effect in correcting inflammatory state and chronic heart failure.
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