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目的 观察慢性肾衰 (CRF)血液透析 (HD)患者中 ,输血传播病毒 (TTV)的感染与患者细胞免疫功能的关系。方法 应用巢式逆转录 -聚合酶链反应 (RT PCR) ,双抗体夹心ELISA法及流式细胞仪 ,分别检测了 90例CRF血透患者和 12 8例对照组血清TTV DNA ,可溶性白细胞介素 2受体 (sIL 2R)和外周血T淋巴细胞亚群。并随机选择对其中1株TTV的部分基因序列进行测定 ,分析TTV与细胞免疫功能、输血次数、HD时间和肝功能的关系。结果 ⑴ 90例CRF血透患者中 ,TTV DNA阳性率为 46 6 7% ,明显高于正常对照组 (P <0 0 0 1) ,与日本报道的TTV DNA序列(AB0 0 8394)相应片段的同源性为 98 5 %。⑵CRF血透患者血清中 ,sIL 2R水平明显高于正常对照组 (P <0 0 1) ;CD3+,CD4+和CD4+/CD8+T细胞比例明显降低 (P <0 0 1)。⑶TTV DNA阳性率与sIL 2R、输血次数及HD时间呈显著的正相关 (r =0 486 ,P <0 0 1;r =0 .5 86 ,P <0 0 0 1;r =0 492 ,P <0 0 1) ,与CD+,CD4+和CD4+/CD8+T细胞比例呈负相关 (r = 0 476 ,P <0 0 1;r = 0 483,P <0 0 1;r= 0 496 ,P <0 0 1) ,而与年龄、性别及手术史均无显著的差别和相关性。结论 CRF血透患者有严重的TTV感染 ;其高发生率可能与细胞免疫功能明显低下及其与血液紧密接触有关
Objective To investigate the relationship between transfusion transmitted virus (TTV) infection and cellular immune function in patients with chronic renal failure (CRF) hemodialysis (HD). Methods Ninety patients with CRF hemodialysis and 128 controls were enrolled in this study. Serum TTV DNA, soluble interleukin 2 receptor (sIL 2R) and peripheral blood T lymphocyte subsets. And randomly selected part of the gene sequence of one TTV was measured, the relationship between TTV and cellular immune function, blood transfusion, HD time and liver function were analyzed. Results (1) Among 90 CRF hemodialysis patients, the positive rate of TTV DNA was 46.67%, which was significantly higher than that of the normal control group (P <0.01 01). The positive rate of TTV DNA in 90 CRF hemodialysis patients was significantly higher than that of the corresponding fragment of TTV DNA sequence (AB0 0 8394) The homology was 98 5%. (2) Serum levels of sIL 2R in CRF hemodialysis patients were significantly higher than those in normal controls (P 0 01). The proportion of CD3 +, CD4 + and CD4 + / CD8 + T cells was significantly decreased (P 0 01). The positive rate of TTV DNA was positively correlated with sIL 2R, blood transfusion times and HD time (r = 0 486, P <0 01; r = 0.586, P 0 01; r 0 492, P <0 01), but negatively correlated with the proportion of CD +, CD4 + and CD4 + / CD8 + T cells (r = 0 476, P <0 01; r 0483, P 0 01; r 0 496, P <0 0 1), but no significant differences and correlations with age, gender and surgical history. Conclusion CRF hemodialysis patients have severe TTV infection; the high incidence may be associated with significantly lower cellular immune function and its close relationship with blood