【摘要】：目的探討血液透析濾過(HDF)對尿毒癥患者中性粒細(xì)胞(PMN)吞噬功能的影響。方法隨機(jī)法選擇尿毒癥患者29例作為治療組。每位患者在維持性血液透析期間均接受1次HDF治療,觀察單次HDF治療治療前、后中性粒細(xì)胞吞噬率(NPR)、中性粒細(xì)胞吞噬指數(shù)(NPI)以及實驗室指標(biāo):血尿素氮(BUN)、血肌酐(SCr)、超敏C反應(yīng)蛋白(Highsensitivity C-reactive protein,hs-CRP)、β2-微球蛋白(β2-microglobulin,β2-MG)、血鉀、血磷的變化。另選擇體檢健康的志愿者25例作為健康組,測定NPR、NPI,作為評價治療組這兩個指標(biāo)的參考標(biāo)準(zhǔn)。白色葡萄球菌按比濁管法配備成6xl08/mL濃度。治療組及健康組的血標(biāo)本與白色葡萄球菌孵育30 min后,涂片,瑞氏-吉姆薩復(fù)合染色法染色,于油鏡下計數(shù)100個PMN,分別記錄吞噬細(xì)菌的細(xì)胞數(shù)和每個PMN吞入的細(xì)菌數(shù),按公式計算NPR和NPI。其余項目送至我院檢驗科檢測。數(shù)據(jù)采用SPSS16.0統(tǒng)計軟件處理,符合正態(tài)分布計量資料以均數(shù)±標(biāo)準(zhǔn)差(?x±s)表示,組間比較采用t檢驗或Wilcoxon秩和檢驗,P0.05為差異有統(tǒng)計學(xué)意義。結(jié)果單次HDF治療前治療組NPR和NPI均低于健康組水平,差異有統(tǒng)計學(xué)意義(P0.05)。HDF治療后患者NPR高于健康組水平,差異有統(tǒng)計學(xué)意義(P0.05),而NPI比較差異無統(tǒng)計學(xué)意義(P0.05)。HDF治療后患者NPR和NPI均高于治療前水平,差異有統(tǒng)計學(xué)意義(P0.05)。單次HDF治療后Bun、Scr及β2-MG濃度較治療前明顯下降,差異均有統(tǒng)計學(xué)意義(P0.05)。HDF治療前后hs-CRP濃度比較差異無統(tǒng)計學(xué)意義(P0.05)。HDF治療后血鉀、血磷濃度較治療前下降,差異均有統(tǒng)計學(xué)意義(P0.05)。結(jié)論尿毒癥患者中性粒細(xì)胞吞噬功能低于健康組水平。單次血液透析濾過治療后尿毒癥患者中性粒細(xì)胞吞噬功能較治療前改善。
[Abstract]:Objective to investigate the effect of hemodiafiltration (HDF) on phagocytosis of neutrophil (PMN) in uremic patients. Methods 29 patients with uremia were randomly selected as treatment group. Each patient was treated with HDF once during maintenance hemodialysis. Before a single HDF treatment, (NPR), neutrophil phagocytosis index (NPI) and laboratory indexes: serum urea nitrogen (BUN), serum creatinine (SCr), serum (SCr), hypersensitive C-reactive protein (hs-CRP), 尾 2-microglobulin (尾 2-MG), serum potassium and blood phosphorus. In addition, 25 healthy volunteers were selected as the healthy group, NPRP NPI was measured as the reference criteria for evaluating these two indexes in the treatment group. Staphylococcus albicans were equipped with 6xl08/mL concentration according to turbid tube method. After incubating with staphylococcus albus for 30 min, the blood samples of the treatment group and the healthy group were stained with Reich's Gimsa staining, 100 PMNs were counted under the oil microscope, and the number of bacteria swallowed by each PMN was recorded. NPR and NPI were calculated according to the formula. The remaining items are sent to the laboratory of our hospital for examination. The data were processed by SPSS16.0 software, and the data of normal distribution were expressed as mean 鹵standard deviation (x 鹵s). The difference between groups was statistically significant by using t test or Wilcoxon rank sum test (P 0.05). Results the levels of NPR and NPI in the single HDF group were significantly lower than those in the healthy group before and after the treatment (P0.05). The level of NPR in the patients was higher than that in the healthy group. The difference was statistically significant (P0.05), but the difference of NPI was not statistically significant (P0.05). After HDF treatment, NPR and NPI were higher than those before treatment, the difference was statistically significant (P0.05). After single HDF treatment, the concentrations of SCR and 尾 2-MG decreased significantly (P0.05). There was no significant difference in hs-CRP concentration before and after treatment (P0.05). Conclusion the phagocytic function of neutrophils in uremic patients is lower than that in healthy controls. The phagocytosis of neutrophils in uremic patients after single hemodiafiltration was improved.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R692.5

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