慢性肾脏疾病患者血清IL-2水平及其临床意义

目的 :探讨检测慢性肾脏疾病 (CKD)患者血清白细胞介素 - 2 (IL - 2 )水平的临床意义。方法 :CKD 6 6例。正常对照组 2 0例。用放射免疫法测定血清IL - 2水平。常规检测其他相关临床指标。分析血清IL - 2水平与肾功能、心血管病变及其他临床资料 (包括血脂、钙磷等 )的关系。结果 :(1)肾功能 3、4、5级患者血清IL - 2水平较正常对照组及肾功能 2级显著升高 (均P <0 .0 5 ) ,相关分析结果表明 ,CKD患者血清IL - 2水平与Scr呈显著正相关 (r=0 .4 4 5 ,P <0 .0 5 ) ,与Ccr呈显著负相关 (r =- 0 .30 1,P <0 .0 5 ) ;(2 )有心血管病变组血清IL - 2水平显著升高于无心血管病变组 (P <0 .0 0 3) ,高血清IL - 2组心血管病变发生率显著高于正常血清IL - 2组 (P <0 .0 1) ;(3) 4 0例肾功能 2～ 5级的CKD患者血清IL - 2水平与甘油三酯、低密度脂蛋白胆固醇、磷呈显著正相关 (P <0 .0 5 ) ,与血钙呈显著负相关 (P <0 .0 1) ,与年龄、病程、血压、总胆固醇、高密度脂蛋白胆固醇、血红蛋白、白蛋白无显著相关 (P >0 .0 5 ) ,进一步逐步回归分析示血清IL - 2水平依次与血钙、内生肌酐清除率、甘油三酯关系最为密切。结论 :CKD患者血清IL - 2水平升高 ,这可能与肾功能减退时严重代谢紊乱 (包括高脂、低钙等 )引起的T细胞

Serum Interleukin-2 Level in Patients with Chronic Kidney Disease and Its Clinical Significance

Objective: To determine the serum interleukin-2(IL-2) level in patients with chronic kidney disease(CKD) and to find out its clinical significance.Methods:According to the standard of NKF-K/DOQI,66 CKD patients and 20 healthy people,served as the control group,were studied.Serum IL-2 level was determined by radioimmunoassay(RIA) method.Other related clinical data were collected at the same time.The relationships between the serum IL-2 levels and kidney function,cardiovascular disease(CVD),and other clinical data,were analysed.Results: (1)The serum IL-2 level was significantly higher in CKD patients with Grade 3,4,5 kidney function than in the control group and in CKD with Grade 2(P<0.05). The serum IL-2 level in 40 CKD patients had a significant positive correlation with the serum creatinine(Scr)(r=0.445,P<0.05),and a significant negative correlation with the endogenous creatinine clearance rate(Ccr) (r=-0.301, P<0.05).(2) Patients with CVD had significantly higher IL-2 level than those without CVD(P<0.003),and the occurrence of CVD in patients with high serum IL-2 level was significantly higher than in patients with normal serum Il-2 levels(P<0.01).(3)The serum IL-2 level in CKD patients with Grade 2-5 had a significant positive correlation with serum triglyceride (TG),low density lipoprotein(LDL),and phosphorus(P)(P<0.05), a significant negative correlation with serum calcium(Ca)(P<0.01), and no correlation with age,course,blood pressure,the level of total cholesterol(TC), high density lipoprotein(HDL), hemoglobin(Hb),and albumin(ALB)(P>0.05).The stepwise regression analysis showed that the serum IL-2 level was most correlated to Ca,Ccr,and TG successively.Conclusion:The serum IL-2 level is markedly elevated in patients with CKD,which is probably related to T lymphycites activation caused by severe metablic disorder when their kidney function is insufficient.In return,high serum IL-2 level is probably contributed to the progress of kidney disease and related to the occurrence of CVD.