血透对尿毒症患者外周血中性粒细胞黏附分子表达的影响

 目的 观察血透时外周血中性粒细胞黏附分子(cell adhesion molecules, CAMs)CD62L、CD11a、CD11b、CD54表达的变化规律,以及不同透析膜对上述细胞黏附分子表达的影响.方法 实验分为血透组和健康对照组,同时血透组又分为铜仿膜组和聚砜膜组;流式细胞仪检测各组外周血中性粒细胞黏附分子CD62L、CD11a、CD11b、CD54的表达.结果 血透组中性粒细胞CD11b表达明显升高,CD62L和CD54表达明显降低;透析不久后,可见2透析组CD11b表达明显上调,CD62L和CD54表达下调.透析结束时CD11b、CD62L及CD54恢复透析前水平;CD11a变化不明显;铜仿膜组CD11b表达较聚砜膜组明显上调(P<0.05).结论 维持性血透可影响中性粒细胞的活性,使细胞表面黏附分子的表达发生规律变化,从而影响尿毒症患者的免疫力,可能增加了感染的机会.黏附分子表达与使用的透析膜的生物相容性相关.

Effects of hemodialysis on expression of cell adhesion molecules in neutrophilic granulocytes from urinemia patients

Objectives To study the change of such adhesion molecules as CD62L, CD1 la, CD1 lb, and CD54 in hemodialysis patients and to study the effect of different dialysis membranes on these adhesion molecules. Methods Twenty - five hemodialysis patients were divived randomly into 2 goups （one with cuprophane, the other with polysulfone membrane） and 23 healthy donors were used as the control group. The above adhesion molecules from peripheral blood were investigated by flow cytometric analysis and immu- nofluorescenee staining method. Results In hemodialysis patients, the expresion of CDllb in granulocytes increased significantly while the expresion of CD62L and CD54 was downregulated markedly, compared with healthy control group. Shortly after hemodialysis, the expression of CD11 b increased while CD62L as well as CD54 decreased significantly, compared with pre - hemodialysis. When he- modialysis ended, the expression of the above adhesion molecules including CD62L, CD1 l b, and CD54 returned to the initiallevel. However, there was no significant change in the expression of CDI la in each stage. Conclusion The regular changes in the expres- sion of adhesion molecules in neutrophilic granulocytes not only affect the activity of leucocytes in a persistent dialysis session , but may also disturb the normal adhesion immune function of leukocytes in dialysis patients and may increase the chance of infection. Some of these changes are associated with the biocompatibility of dialyzer membranes.