轻、中度蛋白尿的慢性肾衰竭患者CD4+T、CD8+T、CD4+/CD8+的变化

摘要

Objective:To discussion the relationships of CD4+ T, CD8+ T and CD4+ /CD8+ changes with albuminuria in chron-ic renal failure. Methods:We collected 137 patients with 24-hour urine protein excretion in 0. 3~3 g among non-dialysischronic kidney disease (CKD). All patients were divided into mild proteinuria (0. 3 g≤24-hour urinary protein<1 g) and moderate pro-teinuria (1 g≤24-hour urinary protein<3 g). Results:In all patients, CD4+ Tand CD4+ /CD8+ were decreased gradually, CD8+ T was gradually increased. In mild proteinuria patients, the changs of CD4+ T, CD8+ T and CD4+ /CD8+ were not significantly different in every CKD period. In moderate proteinuria patients,the changes of CD4+ T, CD8+ T and CD4+ /CD8+ were same with all patients, there was significantly different in CKD5 compared with CKD1~2. CKD3~5 compared with CKD1~2, there were significantly different in CD4+ T and CD4+ /CD8+. Conclusion:Chronic renal failure patients, CD4+ T and CD4+ /CD8+ T cell count were reduced, CD8+ T cell count was rised. These changes may increased as more obvious proteinuria.%目的:探讨在慢性肾衰竭中CD4+T、CD8+T、CD4+/CD8+的变化与蛋白尿之间的关系.方法:共收集24 h尿蛋白定量在0.3~3 g间的137例慢性肾脏病非透析患者,分为轻度蛋白尿组(0.3 g≤24 h尿蛋白定量<1 g)和中度蛋白尿组(1 g≤24 h尿蛋白定量<3 g).采用流式细胞术检测所有患者外周血的CD4+T、CD8+T数量及CD4+/CD8+的比值.结果:所有患者的CD4+T随着肾功能的下降逐步减少,CD8+T随着肾功能的下降逐步上升,CD4+/CD8+随着肾功能的下降逐步降低,CKD4期、CKD5期与CKD1~2期比较差异均有统计学意义.轻度蛋白尿患者CKD各期CD4+T、CD8+T、CD4+/CD8+的变化差异均无统计学意义.中度蛋白尿患者CKD各期CD4+T、CD8+T、CD4+/CD8+的变化趋势与所有患者的总体变化一致,CKD5期与CKD1~2期比较差异均有统计学意义.CKD3~5期与CKD1~2期比较,CD4+T和CD4+/CD8+变化差异均有统计学意义.结论:在慢性肾衰竭中,CD4+T细胞数量减少,D8+T细胞数量上升,CD4+/CD8+降低,这些变化可能随着蛋白尿的增多而越明显.