血液透析患者透析间期体重增长对免疫系统的影响

目的 探讨血液透析患者透析间期体重增长对免疫系统的影响。方法 入选维持性血液透析患者320例,根据透析间期体重增长将患者分为3组,体重增长小于3%为A组(60例)、3%-5%为B组(207例)、大于5%为C组(53例),分析三组患者临床及生化指标的差异。采用线性回归模型探讨透析间期体重增长与淋巴细胞百分比和计数的关系。结果 B组患者的淋巴细胞百分比、淋巴细胞计数均显著低于A组患者(P < 0.01,P < 0.001),C组患者的淋巴百分比、淋巴细胞计数亦显著低于A组患者(P < 0.01,P < 0.001),C组患者的淋巴百分比、淋巴计数显著低于B组患者(P < 0.01、P < 0.001)。多因素线性回归显示透析间期体重增长与淋巴细胞百分比(P < 0.001)和淋巴细胞计数(P < 0.001)呈独立正相关。结论 在血液透析患者,透析间期体重增长是淋巴细胞百分比和计数的独立危险因素。控制透析间期体重增长可能有利于维持患者正常的免疫功能。

Effect of inter-dialytic weight gain on immune system in hemodialysis patients#$NLHu Lin Cao Xue-sen#$NLDepartment of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032 China

Objective To investigate the effect of inter-dialytic weight gain on immune system in hemodialysis patients. Methods Three hundred and twenty maintenance hemodialysis patients were enrolled. According to inter-dialytic weight gain, all patients were divided into 3 groups: group A (inter-dialytic weight gain < 3%, n = 60), group B (inter-dialytic weight gain 3%-5%, n = 207) and group C (inter-dialytic weight gain > 5%, n = 53). The clinical and biochemical characteristics among three groups were analyzed. Linear regression model was employed to investigate the associations of inter-dialytic weight gain with lymphocyte percentage and lymphocyte count. Results The lymphocyte percentage and count in group B were significantly lower than those in group A (P < 0.01 and P < 0.001, respectively). Similarly, the lymphocyte percentage and count in group C were significantly lower than those in group A (P < 0.01 and P < 0.001, respectively). Furthermore, the lymphocyte percentage and count in group C were also significantly lower than those in group B (P < 0.01 and P < 0.001, respectively). Multivariate linear regression revealed that inter-dialytic weight gain was positively correlated with lymphocyte percentage (P < 0.001) and lymphocyte count (P < 0.001) after adjustment for other risk factors. Conclusion Inter-dialytic weight gain was an independent risk factor for lymphocyte percentage and count in hemodialysis patients. Inter-dialytic weight gain control may helpful to maintain the normal immune system in this population.#$NLKeywords: inter-dialytic weight gain; lymphocyte percentage; lymphocyte count; immune function#$NL