中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (44): 8272-8276.doi: 10.3969/j.issn.1673-8225.2011.44.026

• 移植与免疫 transplantation and Immunology • 上一篇    下一篇

维持性血液透析患者外周血单个核细胞核因子κB活性及临床意义

王景福1，张  昆1，胡桂才1，徐素欣2，郭风玲1，赵亚娟1，段书众1，朱菊平1，邢恩鸿3   

  1. 承德医学院附属医院，1肾内科；3中心实验室，河北省承德市  067000；2滦平县疾病预防控制中心检验科，河北省滦平县  068250
  • 收稿日期:2011-06-28 修回日期:2011-07-27 出版日期:2011-10-29 发布日期:2011-10-29
  • 作者简介:王景福★，男，1968年生，河北省承德市人，汉族，2011年河北医科大学毕业，硕士，副主任医师，主要从事慢性肾脏病的营养及血液净化治疗。 wangjingfu1968@sina.com
  • 基金资助:

    承德市科学技术研究与发展计划(自筹经费)项目(201021051)。

Nuclear factor-kappa B activity in peripheral blood mononuclear cells from patients undergoing maintenance hemodialysis and its clinical significance

Wang Jing-fu1, Zhang Kun1, Hu Gui-cai1, Xu Su-xin2, Guo Feng-ling1, Zhao Ya-juan1, Duan Shu-zhong1, Zhu Ju-ping1, Xing En-hong3   

  1. 1Department of Nephrology, 3Central Laboratory, Affiliated Hospital of Chengde Medical College, Chengde  067000, Hebei Province, China; 2Department of Laboratory Medicine, Luanping County Center for Disease Control and Prevention, Luanping  068250, Hebei Province, China
  • Received:2011-06-28 Revised:2011-07-27 Online:2011-10-29 Published:2011-10-29
  • About author:Wang Jing-fu★, Master, Associate chief physician, Department of Nephrology, Affiliated Hospital of Chengde Medical College, Chengde 067000, Hebei Province, China wangjingfu1968@ sina.com
  • Supported by:

    Science and Technology Research and Development Plan Program of Chengde City, No. 201021051*

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摘要：

背景：临床发现肾移植前维持性血液透析患者外周血单个核细胞核因子κB的活性异常增高。
目的：了解肾移植前维持性血液透析患者外周血单个核细胞核因子κB的活性，并探讨其与超敏C-反应蛋白水平、营养不良的关系。
方法：检测肾移植前维持性血液透析患者与健康对照人群营养状态、人体学指标、血液生化指标、外周血单个核细胞核因子κB活性及血清超敏C-反应蛋白水平，据血清超敏C-反应蛋白水平将维持性血液透析患者分为非炎症组(< 3 mg/L)和微炎症组(≥ 3 mg/L)。
结果与结论：①维持性血液透析患者单个核细胞核因子κB活性与血清超敏C-反应蛋白水平显著高于健康对照组(P < 0.001)。②微炎症组营养不良数量及程度、改良主观全面营养评价评分、单个核细胞核因子κB活性及血清超敏C-反应蛋白水平显著高于非炎症组(P ≤ 0.001或P < 0.01或 P < 0.05)。③非炎症组血红蛋白、血清白蛋白、血清前白蛋白、中臂肌围、中臂围、握力均显著低于健康对照组(P ≤ 0.001)，单个核细胞核因子κB活性显著高于健康对照组(P ≤ 0.001)，血清超敏C-反应蛋白水平与健康对照组间差异无显著性意义(P > 0.05)。提示肾移植前维持性血液透析患者普遍存在外周血单个核细胞核因子κB异常活化；随炎症反应加重，C-反应蛋白水平升高，单个核细胞核因子κB活性进一步增强，营养不良加重；说明核因子κB活性可能较血清C-反应蛋白水平更早发现维持性血液透析患者的微炎症状态及预测营养不良。

关键词: 血液透析, 核因子&kappa, B, 超敏C-反应蛋白, 营养不良, 单个核细胞

Abstract:

BACKGROUND: The nuclear factor-κB (NF-κB) activity in peripheral blood mononuclear cells (PBMCs) from patients undergoing maintenance hemodialysis (MHD) before renal transplantation has been found to be increased abnormally.
OBJECTIVE: To investigate NF-κB activity in PBMCs from patients underlying MHD before renal transplantation and its correlation with high sensitive C-reactive protein (hs-CRP) levels and malnutrition.
METHODS: The nutritional status, anthropometric indicators, blood biochemistry, the NF-κB p65 activity in PBMCs and serum hs-CRP level in 71 patients undergoing MHD before renal transplantation and healthy controls were detected. MHD patients were divided into non-inflammatory group (< 3 mg/L) and slight inflammation group (≥ 3 mg/L) according to the hs-CRP levels.
RESULTS AND CONCLUSION: NF-κB activity in PBMCs and serum hs-CRP levels were significantly higher in MHD patients than in healthy controls (P < 0.001). The number of malnutrition patients, the score of modified quantitative subjective global assessment of nutrition (MQSGA), and the NF-κB activity in PBMCs as well as serum hs-CRP level were significantly higher in the slightly inflammatory group than in the non-inflammatory group (P ≤ 0.001 or P < 0.01 or P < 0.05). The hemoglobin, serum albumin, serum prealbumin, mid-arm muscle circumference, mid-arm circumference and grasp force were all significantly lower in the non-inflammatory group than in the non-inflammatory group (P ≤0.001) and the NF-κB activity in PBMCs were significantly higher in the non-inflammatory group than in the healthy control group (P ≤ 0.001), there was no significant difference in serum hs-CRP levels between non-inflammatory group and healthy control group (P > 0.05). Results showed that NF-κB was abnormally activated in PBMCs in patients underlying MHD before renal transplantation; with worsened inflammatory reaction, serum hs-CRP levels and the abnormal activation of NF-κB would be increased and the degree of malnutrition would be more serious. These finding demonstrates that the slight inflammatory status could be detected and malnutrition could be predicted earlier according to NF-κB activity in PBMCs than serum hs-CRP levels.

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