Lucchi L, Cappelli G, Acerbi M A, Spattini A, Lusvarghi E
Nephrology and Dialysis Unit, University Hospital, Modena, Italy.
Nephron. 1989;51(1):44-50. doi: 10.1159/000185241.
Luminol-amplified chemiluminescence was used to study the oxidative metabolism of polymorphonuclear leukocytes (PMN), in resting state and in response to opsonized zymosan, in 65 patients with different degrees of chronic renal failure (CRF) or on regular dialysis treatment (RDT). Every patient was compared on the same day with a normal subject. Furthermore, the serum opsonic activity was evaluated, cross-matching zymosan opsonized by serum from CRF-RDT patients and normals with PMN from CRF-RDT patients and normals. PMN resting chemiluminescence showed a progressive increase inversely related to the glomerular filtration rate, and it remained high in patients on RDT. Zymosan-activated chemiluminescence indicated a deficit in phagocytosis for PMN of patients with a glomerular filtration rate lower than 10 ml/min, persisting in RDT patients. The serum opsonic activity was always significantly lower in CRF and in RDT patients than in the control group; this defect was already present in patients with mild renal impairment. Our findings suggest that PMN from CRF or RDT patients have an increased reactive oxygen metabolite production in the resting state that may cause cell and tissue damage; the opsonization impairment and the decreased PMN phagocytic activity contribute to increased vulnerability to infection in these patients.
采用鲁米诺增强化学发光法，对65例不同程度慢性肾衰竭（CRF）患者或接受定期透析治疗（RDT）的患者，研究其静息状态下及对调理酵母聚糖反应时多形核白细胞（PMN）的氧化代谢情况。每天将每位患者与一名正常受试者进行比较。此外，还评估了血清调理活性，将CRF-RDT患者和正常人的血清调理的酵母聚糖与CRF-RDT患者和正常人的PMN进行交叉匹配。PMN静息化学发光呈进行性增加，与肾小球滤过率呈负相关，且在接受RDT治疗的患者中仍保持较高水平。酵母聚糖激活的化学发光表明，肾小球滤过率低于10 ml/min的患者的PMN吞噬功能存在缺陷，在接受RDT治疗的患者中持续存在。CRF患者和接受RDT治疗的患者的血清调理活性始终显著低于对照组；这种缺陷在轻度肾功能损害患者中就已存在。我们的研究结果表明，CRF患者或接受RDT治疗的患者的PMN在静息状态下产生活性氧代谢产物增加，这可能会导致细胞和组织损伤；调理功能受损和PMN吞噬活性降低导致这些患者对感染的易感性增加。
