尿毒症腹透对大鼠腹膜形态和功能的影响  

Morphologic and functional alterations of peritoneum in uremic rats undergoing peritoneal dialysis

作　　者：袁江姿[1] 钱家麒[1] 方炜[1] 戴慧莉[1] 

机构地区：[1]上海交通大学医学院仁济医院肾脏科,上海200001

出　　处：《上海交通大学学报（医学版）》2007年第10期1189-1192,共4页Journal of Shanghai Jiao tong University:Medical Science

基　　金：上海市科委基金(044119620)~~

摘　　要：目的观察尿毒症腹透对大鼠腹膜血管新生和转运、超滤功能的影响。方法35只雄性Wistar大鼠,随机分为对照组(假手术组,n=6)、尿毒症组(5/6肾切除,n=6)和尿毒症腹透组(n=18);尿毒症腹透组大鼠根据腹透时间不同分成10 d、4周和8周组(n=6)。各组大鼠处死前行腹膜平衡试验,检测腹膜转运功能,并取大网膜进行组织形态学检查。结果大鼠大网膜上每一高倍视野下的血管数,对照组、尿毒症组和尿毒症腹透各时间组分别为1±1、5±3、10±5、17±5和19±4,尿毒症组和尿毒症腹透组显著多于对照组,而尿毒症腹透组又较尿毒症组明显增多(均P<0.05)。腹膜平衡试验结果显示,尿毒症组和尿毒症腹透组大鼠2 h腹透液和血浆肌酐比值(D/PCr)较对照组升高,净超滤量(Net UF)较对照组减少(P<0.05)。血管数变化与2 h D/PCr呈显著正相关(r=0.9038,P<0.001),与Net UF呈显著负相关(r=-0.9168,P<0.05)。结论尿毒症及非生物相容性腹透液均会引起腹膜血管新生,从而导致超滤减少,最终使患者退出腹透。Objective To investigate the morphological and functional alterations of peritoneum in uremic rats undergoing peritoneal dialysis （ PD）. Methods Thirty-five male Wistar rats were randomly divided into control group （ sham operated group, n = 6） , uremia group（5/6 nephrectomy, n =6） and uremia with PD group（ n = 18）. Uremia with PD group was subdivided into three subgroups according to different dialysis period （ 10 d, 4 weeks and 8 weeks, n =6）. Omenta were obtained for morphological examination, and peritoneal equilibration tests （PET） were performed to assess the transport function of peritoneal membrane. Results The number of blood vessels per high-power field in the uremia group, uremia with PD group and uremia with PD subgroups （5 ±3, 10 ±5, 17 ±5 and 19 ±4） were significantly increased compared with the control group （ 1 ± 1 ）, and that was much bigger in the uremia with PD group than the uremia group （ P 〈0.05 for all）. It was revealed by PET that 2 h dialysate to plasma creatinine concentration ratio （D/Pcr） was significantly increased and net ultrafiltration decreased in uremia group and uremia with PD group compared with control group （ P 〈 0.05）. The changes of number of blood vessels were positively correlated with 2 h D/PCr （ r = 0. 9038, P 〈 0. 001 ） and negatively correlated with net ultrafihration （r= -0.9168, P〈0.05）. Conclusion Both uremia and non-biocompatible PD fluid exposure may lead to peritoneal angiogenesis, uhrafiltration failure, and ultimately drop out from PD.

关 键 词：腹膜透析 血管新生 转运功能 超滤 尿毒症 大鼠 

分 类 号：R692.5[医药卫生—泌尿科学] R-33[医药卫生—外科学]