胸腺肽对慢性肾脏疾病患者免疫紊乱的调节

目的探讨胸腺肽对慢性肾脏疾病(chronic kidney disease,CKD)患者外周血T淋巴细胞亚群及NK活性的影响.方法正常对照组23例,CKD组为肾功能正常的患者34例,用胸腺肽50 mg,加入生理盐水100ml中,静脉滴注,每天1次,连续4周.分别测定正常对照组及CKD组治疗前后的外周血T淋巴细胞亚群(CD4,CD8和CD4/CD8)、自然杀伤细胞(NK)活性、血清总蛋白(TP)、血清白蛋白(Al)、血清尿素氮(BUN)、血清肌酐(Scr、补体(C3,C4)及免疫球蛋白(IgG)等指标并进行t检验及相关分析.结果CKD组外周血CD4与CD4/CD8(P＜0.01),NK(P＜0.05)呈正相关,CD8与CD4/CD8呈明显负相关(P＜0.01);IgG与TP,Al(均P＜0.01),NK活性(P＜0.05)呈正相关;补体C3与C4(P＜0 01),CD4/CD8(P＜0.05)呈正相关.CKD组治疗前CD4/CD8,IgG,TP,Al和C3(均P＜0.01)、NK活性(P＜0.05)均低于正常对照组,CD8(P＜0.01)高于正常对照组,且二组之间均差异有显著性.而CD4虽低于正常对照组,但两组之间差异无显著性(P＞0.05).使用胸腺肽静滴治疗4周后,患者CD4、NK活性、Al(均P＜0.01),TP(P＜0.05)较治疗前明显升高,且二者差异有显著性,而CD4/CD8,CD8,C3和C4及IgG虽较治疗前有升高,但二者差异无显著性(均P＞0.05).结论CKD患者存在细胞免疫及体液免疫功能紊乱.胸腺肽通过调节患者外周血CD4和NK活性及TP,Al的水平,从而有效地调节患者免疫紊乱,对肾脏病的治疗起着积极的作用.

Adjustment of thymic peptide on immunologic derangement in chronic kidney disease

Objective:To study the adjustment of thymic peptide on T lymphocyte subset and the activity of nat-ural killer cell of peripheral blood in patients with chronic kidney disease.Methods:The study included23normal control(controls group)and34patients with chronic kidney disease(CKD group)who received intervenous drop in-fusion treatment with thymic peptide50mg plus normal sodium100ml every day,four weeks in all.T lymphocyte subset(CD4,CD8,CD4/CD8),the activity of natural killer cell(NK),serum blood total protein(TP),albumin(Al),blood urea nitrogen(BUN),serum creatinine(Scr),complement(C3,C4)and immunoglobulin(IgG)of peripheral blood were observed in control group and CKD group before and after the four weeks observation,and then analyzed with satistics.Results:In CKD group,CD4was positively correlated with CD4/CD8(P<0.01)and NK(P<0.05);CD8was negatively correlated with CD4/CD8(P<0.01);The same was IgG with TP,Al(allP<0.01)and NK(P<0.05),C3with C4(P<0.01)and CD4/CD8(P<0.05).But CD8was negatively correlated with CD4/CD8(P<0.01).Before treatment,CD4/CD8,IgG,TP,Al,C3(allP<0.01)and NK(P<0.05)in CKD group were all lower but CD8was higher than those of normal group,there was significant deviation between two groups.CD4was lower than thatof normal group and was no significant deviation between two groups (P >0.05). After four weeks treatment, CD4, NK, Al(all P <0.01) and TP (P <0.05) were increased than that of before treatment, while significant deviation between the two. The same were CD4/CD8, CD8, C3, C4 and IgG, while no significant difference between the two (P >0.05). Conclusions: Immunologic derangement of cell immunity and humoral immune function is presented in CKD patients. Thymic peptide is effective to immunologic derangement through adjustment the levels of CD4, NK, TP, Al and can provide positive action in CKD patients.