不同透析膜对血液透析患者外周血单个核细胞分泌IL-10的影响

目的探讨白细胞介素-10（interleukin,IL-10）在维持性血液透析（maintenancehemodialysis,MHD）患者免疫功能缺陷中的作用，判断其能否作为透析膜生物相容性的评价指标。方法应用ELISA法检测外周血单个核细胞（peripheralbloodmononuclearcells,PBMC）受内毒素细菌刺激后培养上清液中IL-10水平。MHD患者分为CA组和PUS组，另设立尿毒症未透析组（non-hemodialysis,NHD组）和健康对照组。结果在各组患者的PBMC培养上清液中均未检测到血浆IL-10。经内毒素刺激后，上清液中IL-10水平升高，其中PS组高于CA组，但各组升高幅度均低于健康对照组。结论应用生物相容性较好的PS膜可改善患者的免疫细胞对抗原的反应能力，IL-10可以作为评价透析膜生物相容性的指标之一。

Role of Interleukin-10 in the Maintenance of Hemodialysis in Patients With Immune Deficiency

Objective: To determine the role of interleukin-10 (IL-10) secreted by peripheral blood mononuclear cells (PBMC) in the maintenance of hemodialysis in patients with immune deficiency and to evaluate thot if IL-10 can bea biocompatibility index of dialyzer. Methods: Twenty patients with end-stage renal disease were divided into maintenance hemodialysis group (MHD group) and non-hemodialysis group (NHD group). Patients in MHD group were dialyzed with cellulose (CA group) and polysulfone (PS group) dialyzers respectively. Ten healthy persons were as controls (CON group). The levels of IL-10 in supernatants of PBMC cultured with or without lipopolysaccharide (LPS) were measured by using ELISA method in all groups. Results: There was no spontanous IL-10 secretion in all groups. The level of IL-10 in all supernatants secreted by PBMC cultured with LPS increased significantly, and the increased levels of IL-10 in MHD and NHD patients were lower than that in controls. The PBMC stimulated by LPS secreted more IL-10 in patients dialyzed by PS with better biocompatibility than those of CA dialyzers with poor biocompatibility. Conclusion: Patients immune deficiency could be improved by using better biocompatible dialyzers more than poor ones, particularly in humoral immunity induced by urimia. The IL-10 could be a parameter in evaluating the biocompatibility of dialyzer.