摘要
目的 探讨血透对可溶性细胞粘附分子表达的影响。方法 观察２２ 例尿毒症血透患者透析前、透析１５ 分钟及透析５ 小时后血中可溶性ｓ Ｉ Ｃ Ａ Ｍ１ 和血浆 Ｐ选择素的水平，同时相应进行血白细胞计数。结果 患者透析１５ 分钟时的血白细胞显著低于透析前水平，透析５ 小时后接近透析前水平，两者差异无显著性。透析前ｓ Ｉ Ｃ Ａ Ｍ１ 水平高于正常对照组，透析１５ 分钟时静脉端显著低于透析前水平，但高于动脉端水平，透析５ 小时后其值仍低于透析前水平。血浆 Ｐ选择素水平透析前显著高于正常对照组，透析１５ 分钟时较透析前明显增高，透析５ 小时后与透析前水平相比差异无显著性。结论 透析过程中白细胞减少可能与ｓ Ｉ Ｃ Ａ Ｍ１ 和血浆 Ｐ选择素作用有关；ｓ Ｉ Ｃ Ａ Ｍ１ 和 Ｐ选择素的改变是造成血透患者免疫功能缺陷的重要因素之一；血透患者高凝状态可能是 Ｐ选择素参与或促进血栓形成的一个重要因素。
Objective To study the effect of hemodialysis(HD) on the soluble cell adhesion molecules expression. Methods We observed the levels of soluble intercellular adhesion molecule 1(sICAM 1), P selectin and white blood cells(WBC) in twenty two hemodialysis patients.Results WBC counts were decreased after 15 minutes of HD session compared with those of the baseline( P < 0.05 ). After 5 hour HD, the counts were closed to predialysis levels, there was no significant difference between the two situations( P >0.05). The levels of sICAM 1 at predialysis were significant higher than those of the controls( P <0.01). Early in HD, sICAM 1 levels, though lower than those of predialysis, were elevated in the exit line of the dialyzer compared with those at entrance( P <0.05). The levels of sICAM 1 after 5 hour HD were still lower than the levels of predialysis. The levels of plasma P selectin at predialysis were significantly increased after 15 minutes HD. On 5 hour HD session, the levels of P selectin were close to predialysis levels.Conclusions Dialysis associated leukopenia may be related to the effects of sICAM 1 and P selectin. Alterations in serum levels of sICAM 1 and P selectin may play a role in the defects in immunity resulting in dialyzed patients. P selectin may promote thrombogenesis in HD patients with hypercoagulable state.(Shanghai Med J,1999,22:536 538)
出处
《上海医学》
CAS
CSCD
北大核心
1999年第9期536-538,共3页
Shanghai Medical Journal
关键词
P-选择素
血液透析
SICAM-1
Cell adhesion molecule Soluble intercellular adhesion molecule 1 P selectin Hemodialysis
