腹膜透析患者血清蛋白结合毒素水平及影响因素分析

发布时间：2018-01-01 02:33

本文关键词：腹膜透析患者血清蛋白结合毒素水平及影响因素分析　出处：《第二军医大学学报》2017年10期 　论文类型：期刊论文

【摘要】：目的比较腹膜透析(PD)患者与健康人群血清蛋白结合毒素(PBT)代表物质硫酸吲哚酚(IS)和硫酸对甲酚(PCS)水平的差异,并探讨影响IS及PCS水平的因素。方法纳入2015年2月至7月第二军医大学长征医院腹透中心符合入选标准的72例PD患者及同期体检中心的24例健康志愿者,采集空腹静脉血3mL。采用高效液相色谱-电喷雾电离串联质谱法(HPLC-ESI-MS/MS)检测血清中总IS、PCS以及游离IS、PCS浓度,采用简单线性相关及多元线性回归方法分析IS、PCS与年龄、性别、小分子毒素、腹透充分性、残余肾功能、营养及C-反应蛋白(CRP)等因素的相关性。结果 PD患者血清总IS及总PCS浓度高于健康志愿者(P0.001)。无残肾功能PD患者血清总IS浓度高于有残肾功能者(P=0.001)。血清总IS与血清游离IS(r=0.719,P0.01)、透析龄(r=0.306,P0.01)呈正相关,与残肾尿素清除指数(Kt/V;r=-0.372,P0.01)、残肾肌酐清除率(Ccr;r=-0.515,P0.01)、残肾肾小球滤过率估计值(eGFR;r=-0.495,P0.01)呈负相关。血清游离IS与残肾Ccr(r=-0.430,P0.01)、残肾eGFR(r=-0.431,P0.01)负相关。血清总IS和游离IS均与年龄、血红蛋白、CRP无明显相关性。结论 PD患者血清IS水平与患者残肾功能呈负相关,与年龄、性别和CRP无明显相关性,提示保护残肾功能有利于PD患者清除血清中的IS。
[Abstract]:Objective to compare the peritoneal dialysis (PD) patients and healthy human serum protein binding toxin (PBT) on behalf of the material indoxyl sulfate (IS) and p-cresol sulfate (PCS) level differences, and to explore the influencing factors of the IS and PCS level. Methods: 24 healthy volunteers were included in the dialysis center of Changzheng Hospital from February 2015 to July with 72 cases of Second Military Medical University PD patients and medical examination center of the selected standard, fasting venous blood 3mL. by high performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) detection of serum total IS, PCS and free IS, the concentration of PCS, using simple linear correlation and multiple linear regression analysis of IS, PCS and age, gender, small molecule toxin, peritoneal dialysis adequacy and residual renal function, nutritional and C- reactive protein (CRP) correlation factors. Results the serum total IS and total PCS in patients with PD was significantly higher than that in healthy volunteers (P0.001). No residual renal function PD The concentration of serum total IS was higher than that of residual renal function (P=0.001). The total serum IS and serum IS (r=0.719, P0.01), dialysis age (r=0.306, P0.01) were positively correlated with residual renal urea clearance index (Kt/V; r=-0.372, P0.01), residual renal creatinine clearance rate (Ccr; r=-0.515, P0.01) the remnant kidney, estimated glomerular filtration rate (r=-0.495, eGFR; P0.01). Serum IS was negatively correlated with residual renal Ccr (r=-0.430, P0.01), eGFR (r=-0.431, residual kidney P0.01) negative correlation. Serum total IS and free IS were associated with age, hemoglobin CRP, there was no significant correlation between serum IS level. Patients with PD had negative correlation with residual renal function in patients with no significant correlation with age, gender and CRP, suggesting that protection of residual renal function in patients with PD is beneficial to the clearance of serum IS.

【作者单位】：第二军医大学长征医院肾内科;
【基金】：国家自然科学基金(81570621)~~
【分类号】：R459.5
【正文快照】： [Acad J Sec Mil Med Univ,2017,38(10):1238-1243]腹膜透析(peritoneal dialysis,PD)是肾脏替代治疗的重要方式之一,利用自身腹膜等半透膜的作用,缓慢持续清除体内潴留的代谢产物和过多的水分,达到肾脏替代或支持治疗的目的。越来越多的研究表明,蛋白结合毒素(protein-bound

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