慢性腎不全患者の免疫能に関する研究 第1報 : 慢性血液透析患者におけるPPD,PHA皮内反応およびPHA刺激によるリンパ球幼若化能について

Abstract

The immune response in 55 uremic patients maintained on hemodialysis was measured with PPD, PHA skin test and PHA induced blastoid transformation of peripheral lymphocytes in in vitro system. Positive rate of PPD skin test was 62% in uremic patients, which was low in general Japanese adults. Mean diameter of erythema of skin reaction at 48 hours after the intradermal injection of 5 µg PHA was 21.1±11.8 (mean±SD) mm in uremic patients and 36.6±17.3 mm in normal control subjects. The difference between them was significant at P<0.001 Blastoid transformation of lymphocytes was determined with quantitation of tritium thymidine incorporation (cpm) and the ratio of blastogenasis was revealed as stimulation index (SI). S1 was 32.1±25.5 in uremic patients and 50.2±27.2 in control subjects. The difference between them was significant at P<O.OI. S1 was low in the uremic patients with high serum creatinine level. On this investigation, cellular immune response was reduced in uremic patients and lymphocyte transformation using whole blood culture was useful method for evaluation of cellular immune competence in severe anemic patients.