慢性透析患者の免疫動態と免疫補充療法

抄録

To elucidate the immune-behaviour and susceptibility to infections in haemodialyzed patients, we performed various immune-serological examinations in 371 dialyzed patients caused by chronic nephritis. The results revealed significant reductions in the peripheral leukocyte count, lymphocyte count, T cell count, B cell count and IgG-FcR⁺T cell count and a significant increase in the serum-IgG level in these patients compared with normal levels. The CH 50 and C 3 levels were significantly lowered. PPD and PHA Skin reaction were negative in 59.3% and 54.0% of the patients, respectively. In dialyzed patients, both cellular and humoral immunity is very likely to be suppressed. As the involvement of many factors other than those determined this report is suspected, furthermore it's necessary for us to make investigation into other factors. Then we studied immune-supplemental therapy for the treatment of infections in the dialyzed patients. 32 patients who had not responded to 3-day administration of antibiotics were treated with the intravenous immunoglobulin preparation (Gamma-Venin ^(R)) in addition to the antibiotics. This combination normalized the peripheral leukocyte count, elevated the serum-IgA and-IgG levels and improved the CRP. The antipyretic activity of this treatment was noticeable. Therefore, concomitant use of the intravenous immunoglobulin preparation with antibiotics appears to be effective against infections in the dialysed patients.