不同腹膜转运特性对腹膜透析患者腹膜透析流出液中VEGF、ET-1及UA的影响

发布时间：2018-06-09 23:38

本文选题：VEGF + ET-1　；参考：《山西医科大学》2017年硕士论文

【摘要】：目的:探讨不同腹膜转运特性对腹膜透析患者腹膜透析流出液中VEGF、ET-1及UA的影响,为保护腹膜、防治腹膜超滤功能衰竭提供实验依据。方法:选取本院2015年12月~2016年12月行PD的住院患者40例,通过判断腹膜转运特性(PET)的结果,依照PET结果,将入组PD患者分成2个组:高转运组(高转运与高平均转运),低转运组(低转运与低平均转运)。(1)记录患者24h的尿量及超滤量;(2)患者血液送至本院检验科,化验血红蛋白、血清白蛋白、血钙、血磷、甲状旁腺激素、血尿素氮、血肌酐、血钾、血钠等生化指标;(3)依据公式计算KT/V为尿素的清除指数,RRF评价残余肾功能;(4)同时用尿酸酶法测腹膜透析流出液中UA,ELISA法测定腹膜透析流出液中VEGF、ET-1的浓度;(5)用t检验的方法比较两组患者腹膜透析流出液中VEGF、ET-1、UA的水平,用Pearson相关分析,分析腹膜透析流出液中VEGF、ET-1、UA与超滤量、尿量的相关性。结果:1.与低转运组相比,高转运组血液中BUN、Scr、Alb浓度明显降低。2.高转运组患者超滤量、RRF、尿量明显低于低转运组。3.高转运组腹膜透析流出液中VEGF、UA浓度与低转运组相比明显升高;高转运组与低转运组相比,ET-1的浓度无差异(P0.05)。4.腹膜透析流出液中VEGF、UA水平与超滤量呈负相关(R=-0.402、-0.378,P0.05),腹膜透析流出液中VEGF、UA水平与尿量呈负相关(R=-0.323、-0.345,P0.05),而腹膜透析流出液中的ET-1水平与超滤量、尿量之间没有相关性(P0.05)。结论:1.通过本实验结果分析证实,腹膜透析流出液中VEGF、UA水平升高会导致腹膜损伤、腹膜纤维化等腹膜透析并发症;2.如果降低腹膜透析流出液中VEGF、UA水平,能够防止腹膜透析纤维化等并发症的发生;3.本实验完善了引起腹膜透析并发症的影响因素,为腹膜透析并发症防治的研究提供实验依据。
[Abstract]:Objective: to investigate the effects of different peritoneal transport characteristics on VEGFFftET-1 and UA in peritoneal dialysis effluents of peritoneal dialysis patients, in order to provide experimental evidence for protecting peritoneum and preventing and treating peritoneal ultrafiltration failure. Methods: forty patients with PD from December 2015 to December 2016 in our hospital were selected. According to the results of PET, the characteristics of peritoneal transport were determined. PD patients were divided into two groups: high transport group (high transport group and high average transport group) and low transport group (low transport and low average transport group). Serum albumin, serum calcium, blood phosphorus, parathyroid hormone, blood urea nitrogen, serum creatinine, blood potassium, The RRF evaluation of residual renal function with KT / V as urea was calculated according to the formula. At the same time, the concentration of VEGFFET-1 in peritoneal dialysis effluents was determined by using uric acid enzyme method, and the concentration of VEGFFFET-1 in peritoneal dialysis effluents was determined by Elisa) t test was used to determine the concentration of VEGFFET-1 in peritoneal dialysis effluents. Methods the levels of et 1 UA in peritoneal dialysis effluents were compared between the two groups. Pearson correlation analysis was used to analyze the correlation between VEGF et 1 UA and ultrafiltration volume and urine volume in peritoneal dialysis effluents. The result is 1: 1. Compared with the low transport group, the blood BUNN Scr-Alb concentration in the high transport group was significantly lower than that in the low transport group. The RRFs and urine volume in the high transport group were significantly lower than those in the low transport group. The concentration of VEGF UA in peritoneal dialysis effluents in high transport group was significantly higher than that in low transport group, but there was no difference between high transport group and low transport group. The level of VEGFU UA in peritoneal dialysis effluents was negatively correlated with ultrafiltration, but there was no correlation between the level of VEGFU UA and urine volume. However, there was no correlation between the levels of et 1 and ultrafiltration in peritoneal dialysis effluents, and there was no correlation between the levels of VEGFU UA and urine volume (P 0.05), while the levels of VEGFU in peritoneal dialysis effluents were negatively correlated with the volume of urine (P 0.05), while the levels of VEGFU in peritoneal dialysis effluents were negatively correlated with the volume of urine (P 0.05). Conclusion 1. The results of this study confirmed that the elevated level of VEGF UA in peritoneal dialysis effluents would lead to peritoneal injury, peritoneal fibrosis and other peritoneal dialysis complications. If we reduce the level of VEGF UA in peritoneal dialysis effluents, we can prevent complications such as peritoneal dialysis fibrosis. This experiment improved the influencing factors of peritoneal dialysis complications and provided experimental basis for the prevention and treatment of peritoneal dialysis complications.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R692.5

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