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目的:探讨慢性肾脏病(CKD)患者红细胞免疫功能与肾小球滤过率(eGFR)及甲状旁腺激素(PTH)的相关性。方法:CKD患者60例,按eGFR分为CKD1-2期、CKD3-4期、非透析CKD5期组,每组各20例,同期正常体检者20例为健康对照组。全段甲状旁腺激素(iPTH)采用放射免疫法检测;红细胞免疫功能以红细胞膜C3b受体花环率(RCR)表示,采用郭峰法检测。结果:随着eGFR下降,iPTH水平逐渐升高,RCR进行性下降,CKD3-4期组及CKD5期组与健康对照组及CKD1-2期组比较差异均有统计学意义(均P<0.05);随着肾功能减退,Hb下降,CKD3-4期组及CKD5期组与健康对照组及CKD1-2期组比较差异均有统计学意义(均P<0.05);随着肾功能减退钙磷代谢紊乱加重,CKD5期组血钙明显降低、血磷显著升高,血钙及血磷与CKD1-2期组及CKD3-4期组比较差异有统计学意义(均P<0.05)。Pearson相关分析:CKD3-4期组及CKD5期组患者RCR与iPTH水平呈负相关(r=-0.36,P<0.05),与Hb呈正相关(r=0.46,P<0.05),与eGFR呈正相关(r=0.41、P<0.05)。结论:肾功能减退及PTH异常升高可导致CKD患者红细胞免疫功能低下。
Objective: To investigate the correlation between erythrocyte immune function and glomerular filtration rate (eGFR) and parathyroid hormone (PTH) in patients with chronic kidney disease (CKD). Methods: Sixty CKD patients were divided into CKD1-2, CKD3-4, and non-dialysis CKD5 groups according to eGFR. Twenty patients in each group had 20 cases of normal CKD, and 20 cases of normal subjects were healthy controls. The whole parathyroid hormone (iPTH) was detected by radioimmunoassay. The erythrocyte immune function was expressed by rosette membrane C3b rosette rate (RCR) and was detected by Guo Feng method. Results: With the decrease of eGFR, the levels of iPTH and RCR decreased gradually. The differences between CKD3-4 group and CKD5 group and healthy control group and CKD1-2 group were statistically significant (all P <0.05) ; With renal dysfunction, Hb decreased, CKD3-4 group and CKD5 group and healthy control group and CKD1-2 group differences were statistically significant (P <0.05); with renal dysfunction, calcium Metabolic disorders increased, CKD5 group decreased serum calcium, phosphorus increased significantly, serum calcium and phosphorus and CKD1-2 group and CKD3-4 group, the difference was statistically significant (P <0.05). Pearson correlation analysis: There was a negative correlation between RCR and iPTH levels in patients with CKD3-4 and CKD5 (r = -0.36, P <0.05), positive correlation with Hb (r = 0.46, P <0.05) (r = 0.41, P <0.05). CONCLUSIONS: Renal dysfunction and abnormal PTH may lead to an impaired erythrocyte immune function in CKD patients.