血液透析对白细胞粘附分子表达调节的影响.docVIP

???? 血液透析对白细胞粘附分子表达调节的影响 ???? ????【摘要】　目的　探讨血透中粒细胞和单核细胞表面粘附分子表达的变化规律及其对长期透析患者免疫能力下降的可能作用。方法　采用流式细胞分析技术检测血透患者粒细胞和单核细胞表面CD11b、CD45、CD54和L-selectin在透析中的表达水平，并观察了不同的透析膜对其变化的影响；同时测定外周血中上述两种细胞的数量。结果　透析开始后，细胞表面CD11b的表达迅速上升，而L-selectin则显著下降，同时伴随外周血细胞计数的减少；铜仿膜组的变化显著大于聚砜膜组。CD45的变化与CD11b的变化相似；二组患者细胞表面CD54在整个透析过程中基本无变化。结论　白细胞表面粘附分子在血透中有规律的变化，导致了外周血白细胞减少，同时可能损害了白细胞的正常粘附能力，降低了机体的免疫力；而这些变化与使用的透析膜的生物不相容性有关。　　【关键词】　血液透析　透析膜　粘附分子　白细胞　生物相容性 The effects on the expression of leukocyte adhesion molecules during hemodialysis QIAN Jiaqi*，XU Xiaoqi,SHI Xuegeng，et al.*Renal Division,Renji Hospital,Shanghai Second Medical University,Shanghai 200001 　　【Abstract】　Objective　To investigate the trends of leukocyte adhesion molecules expression by hemodialysis therapy,and the relationship between these changes with the impaired immunity in long-term hemodialysis patients.Methods　The expressions of CD11b,CD45,CD54 and L-selectin on granulocytes and monocytes during dialysis with different dialyzer membranes were assessed by flow cytometry and the cells numbers were counted concomitantly.Results　Shortly after hemodialysis the expression of CD11b increased rapidly,while that of L-sclectin decreased and also did the cells numbers.The magnitudes of these changes on CU were larger than those on PS.The overexpression of CD45 was similar to that of CD11b,while there was no significant change in the expression of CD54 during dialysis on either of membrane group.Conclusion　The regular changes in the expression of adhesion molecules on leukcoytes not only lead to the leukopenia occuring in a dialysis session,but may also disturb the normal adhesion immune function of leukocytes in dialysis patients.All of these changes are associated with the dialyzer membranesbiocompatibility.　　【Key wrods】　Hemodialysis　Dialyzer membrane　Adhesion molecule　Leukocyte　Biocompatibility 　　细胞粘附分子是近年来发现的一类来自不同基因的配体/受体分子，它们介导了细胞信息传递的关键步骤［1］。与白细胞有关的粘附分子在白细胞趋化、吞噬、脱颗粒、释放溶酶体、产生超氧离子等过程中有重要的生物学意义。白细胞共同抗原(CD45)为所有白细胞表面广泛表达的一种具酪氨酸磷酸酶活性