终末期肾脏病患者细胞免疫与营养状况的关系

目的 观察终末期肾脏病（ESRD）患者细胞免疫和营养状况，并分析其相关性。方法选择2000年8月至2009年5月我院住院和门诊的ESRD患者40例，其中20例接受血液透析治疗（Ⅰ组），20例未接受血液透析治疗（Ⅱ组），选择同期健康体检者20名为Ⅲ组。检测3组T细胞亚群、体质量指数、上臂肌嗣、血清蛋白质、血脂和电解质，并对ESRD患者的细胞免疫指标与营养状况指标进行相关性分析。结果（1）与Ⅲ组比较，ESRD患者血清蛋白水平低，血脂代谢异常，T细胞数减少和T细胞亚群分布异常（P〈0．05）；（2）与Ⅱ组比较，Ⅰ组CD3＋、CD4＋T细胞数升高（P〈0．05）；（3）ESRD患者血清总蛋白、清蛋白、总胆固醇分别与CD3＋、CD4＋T细胞数呈正相关（P〈0．05）。结论ESRD患者存在细胞免疫缺陷和营养不良，两者存在显著相关性，透析治疗可改善ESRD患者细胞免疫功能。

Correlation between cellular immune function and nutritional status in patients with end-stage renal disease

Objective To investigate the change of cellular immune function and nutritional status of end-stage renal disease （ESRD）, and analyze their correlation. Methods Forty ESRD patients in our hospital during Aug. 2000 to May. 2009 were enrolled. Twenty cases received hemodialysis as group Ⅰ, and the rest 20 patients were not subjected to hemodialysis as group Ⅱ Twenty healthy persons over the same period served as group Ⅲ. T lymphocyte subsets, body mass index, arm muscle circumference, serum proteins, lipids and electrolytes were detected, and the correlation between cellular immune function and nutritional status was analyzed in ESRD patients. Results （1） As compared with group Ⅲ ESRD patients had low serum levels of protein, lipid metabolic disorders, the decreased percentage of T cells and abnormal distribution of T cell subsets （P〈0. 05） ; （2） As compared with group Ⅱ , CD3＋ and CD4＋ T cells in group Ⅰ were decreased （P〈0. 05） ; （3） The serum levels of total protein, albumin, cholesterol in ESRD patients were positively correlated with the percentage of CD3＋ , CD4＋ T cells respectively （P〈0. 05）. Conclusion Malnutrition and cellular immune deficiency exists in ESRD patients, and there is significant correlation between them. Hemodialysis can improve the cellular immune function in ESRD patients.