分析尿毒症血液透析患者血清甲状旁腺激素(PTH)、铁蛋白(SF)及辅助性T细胞(Thelpercell22,Th22)/调节性T细胞(Tregulatorycells，Treg)变化的临床意义。方法回顾性分析2020年1月～2021年1月在武汉市江夏区第一人民医院进行血液透析的尿毒症患者65例，记录患者血清SF、PTH水平及Th22/Treg细胞和炎症因子水平情况，尿毒症血液透析患者血清SF、PTH水平及炎性因子水平和Th22细胞、Treg细胞相关性，Th22、Treg对尿毒症血液透析患者微炎症状态的预测价值。结果观察组透析后3个月、6个月后SF水平(t=14.628、31.273，P=0.001、0.001)、PTH水平(t=50.507、74.221，均P＜0.001)、Th22细胞比率(t=4.424、9.807，P=0.001、0.001)高于对照组；观察组透析后3个月、6个月后Treg细胞比率低于对照组(t=10.535、17.050，P=0.001、0.001)。结论临床尿毒症血液透析患者血清PTH、SF水平和Th22细胞比例异常升高，Treg细胞比例异常降低，它们的异常表达和患者微炎症状态相关，Th22/Treg可能当作尿毒症血液透析患者微炎症状态预测因子。
Objective To investigate the clinical significance of changes of serum parathyroid hormone (PTH), serum ferritin (SF) and Th22/Treg cells in uremic patients with hemodialysis. Methods A total of 65 uremia patients undergoing hemodialysis from January 2020 to January 2021 and treated in The First People’s Hospital of Jiangxia District Wuhan City were retrospectively reviewed. Their serum PTH, SF and inflammatory factors, and Th22/Treg cells were recorded. The correlation between Th22/Treg cells and serum levels of PTH, SF and inflammatory factors and the predictive value of Th22/Treg cells for micro-inflammatory state in these hemodialysis patients were evaluated. Results In uremic patients after hemodialysis for 3 and 6 months, serum SF levels were (132.34±20.77)ng/ml and (201.92±25.80)ng/ml respectively, higher than the serum SF of (85.49±15.34)ng/ml in control group (t=14.628 and 31.273, P=0.001); serum PTH levels were (153.92±15.48)pg/ml and (238.60±19.44)pg/ml respectively, higher than the serum PTH of (30.43±10.95) ng/ml in control group (t=50.507 and 74.221, P=0.000); Th22 cell ratios were (1.15±0.26)% and (1.35±0.24)%, higher than the ratio of (0.97±0.20)% in control group (t=4.424 and 9.807, P=0.001); Treg cell ratios were (1.46±0.19)% and (1.25±0.19)%, lower than the ratio of 1.86±0.24% in control group (t=10.535 and 17.050, P=0.001). Conclusion In uremic patients undergoing hemodialysis, serum PTH, serum SF and Th22 cell ratio increased, while Treg ratio decreased. These abnormalities are related to the micro-inflammatory state of the patients. Th22/Treg may be regarded as the predictor factors for micro-inflammatory state in hemodialysis patients.
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