黄芪对尿毒症患者血浆sFasL及外周血淋巴细胞亚群状态的作用

目的 :通过测定血浆中sFasL水平和外周血T淋巴细胞亚群状态的分析 ,探讨黄芪对改善尿毒症患者肾功能可能的机制。方法 :采用流式细胞仪和ELISA方法测定 2 5例尿毒症患者黄芪治疗前后及 2 0例正常人血浆中sFasL水平和外周血淋巴细胞亚群状态 ,以及患者治疗前后的肾功能变化。结果 :与正常人比较 ,尿毒症患者血浆中可溶性Fas配体 (sFasL)水平明显升高 ;CD3 CD4 细胞的百分率明显下降 ,CD8 细胞的百分率明显升高 ,CD4 /CD8 的比例小于 1(P <0 .0 1)。 2 5例患者黄芪治疗后血浆中sFasL水平降低 (P <0 .0 5 )。CD4 /CD8 的比例升高 (P <0 .0 1) ;肌酐 (Scr)和尿素氮 (BUN)水平亦有不同程度降低 (P <0 .0 5 )。且动态观察 12例尿毒症患者血肌酐和尿素氮的下降与血浆中sFasL水平的下调呈正相关 (r =0 .5 6 ,P <0 .0 1)。结论 :黄芪能改善尿毒症患者的肾功能 ,提高患者的细胞免疫功能及减慢患者的细胞凋亡是其可能的机制之一。

Effect of Radix Astragali on sFasL and T Cell Subsets in Patients with Uremia

Objective:To investigate the possible mechanisms of radix astragali in improving renal function in uremic patients. Methods: 20 normal volunteers were selected as controls and 25 patients were enrolled in the study. Plasma sFasL was tested by ELISA and T cell subset was tested by flow cytometry. Renal function was also analyzed. Results: Compared to normal controls, plasma sFasL level was elevated and the percentage of CD 3 CD 4 subset decreased significantly. The percentage of CD 8 subset increased and the ratio of CD 4 /CD 8 was less than 1(P<0.01). sFasL decreased and the ratio of CD 4 /CD 8 increased after astragali treatment (P<0.05). Serum creatinine and urea nitrogen also decreased(P<0.05). Plasma creatinine and urea nitrogen during the period of the treatment was positively correlated with plasma sFasL. Conclusion: Improving cellular immune function and modifying apoptosis may be the mechanisms of radix astragali in improving renal function for uremic patients.