腹膜透析患者腹腔血管内皮生长因子及肿瘤坏死因子-α水平对腹膜溶质转运功能的影响

发布时间：2018-05-16 13:17

  本文选题：腹膜透析 + 血管内皮生长因子　； 参考：《中国老年学杂志》2016年03期

【摘要】：目的探讨腹膜透析患者腹腔血管内皮生长因子(VEGF)及肿瘤坏死因子(TNF)-α水平对腹膜溶质转运功能的影响。方法回顾性分析该院2009~2012年收治的154例稳定持续非卧床腹膜透析(CAPD)患者临床资料,计算肌酐溶质转运面积系数(MTACc)评价其腹膜溶质转运功能,分析基线及12个月后的MTACc水平及变化程度(ΔTACcr),同时采用酶联免疫吸附法检测腹膜透析液中的VEGF及TNF-α水平并计算两者呈现率(AR),分析总体、腹膜溶质转运功能稳定组(ΔTACcr均数)和升高组(ΔTACcr≥均数)的VEGF AR和TNF-αAR水平,根据四分位数间距将VEGF AR(≤56.47、56.48~75.23、75.24~98.17、98.18 pg/min)和TNF-αAR(≤22.57、22.58~36.91、36.92~47.55、47.56 pg/min)分为4个亚组,比较各亚组的基线资料,采用单因素和多因素Cox回归分析影响腹膜溶质转运功能的因素。结果全组12个月后的MTACc为(7.28±0.92)ml/min,高于基线MTACc水平(P0.05);ΔTACcr为(0.87±0.26)ml/min,其中85例0.87 ml/min(稳定组)和69例≥0.87 ml/min(升高组),ΔTACcr水平与VEGF AR及TNF-αAR均呈正相关(r=0.421、0.554,P均0.05)。稳定组与升高组的腹膜Kt/V、残肾功能、尿量、VEGF AR及TNF-αAR的差异有统计学意义(P0.05);腹膜Kt/V随VEGF AR、TNF-αAR水平升高而明显增加,残肾功能、尿量随VEGF AR、TNF-αAR水平升高而明显降低(P0.05),且VEGF AR随TNF-αAR水平亦升高(P0.05);影响腹膜溶质转运功能的因素有腹膜Kt/V、残肾功能、尿量、VEGF AR及TNF-αAR,且以VEGF AR≤80 pg/min为参照,80 pg/min腹膜溶质转运功能增强的风险为11.965倍(95CI:5.416~26.434),而以TNF-αAR≤30pg/min为参照,30 pg/min的风险为7.997倍(95CI:3.813~16.776)。结论腹腔局部炎症反应及血管新生情况可影响腹膜溶质转运功能,腹膜透析液中的VEGF及TNF-α水平是预测腹膜溶质转运功能改变的风险因素。
[Abstract]:Objective to investigate the effects of vascular endothelial growth factor (VEGF) and tumor necrosis factor (TNF- 伪) on peritoneal solute transport in peritoneal dialysis patients. Methods the clinical data of 154 patients with stable continuous ambulatory peritoneal dialysis (CAPDD) admitted in our hospital from 2009 to 2012 were retrospectively analyzed and their peritoneal solute transport function was evaluated by calculating the creatinine solute transport area coefficient (MTACc). The levels and changes of MTACc in baseline and 12 months were analyzed. The levels of VEGF and TNF- 伪 in peritoneal dialysate were detected by enzyme-linked immunosorbent assay (Elisa). The levels of VEGF AR and TNF- 伪 AR in peritoneal solute transport function stable group (螖 TACcr mean) and elevated group (螖 TACcr 鈮，

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