腹膜透析患者腹膜电荷屏障对透析液蛋白质丢失的影响  

Peritoneal charge barrier and the protein loss in patients of continous ambulatory peritoneal dialysis patient

作　　者：俞国庆[1] 文文[2] 陈建[1] 庄永泽[1] 林沁[1] 彭卫华[1] 王丽萍[1] 

机构地区：[1]南京军区福州总医院肾内科,350025 [2]南京军区福州总医院呼吸内科

出　　处：《肾脏病与透析肾移植杂志》2008年第4期335-338,共4页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：福建省科技厅青年创新基金资助(2004J068)

摘　　要：目的:测定持续非卧床腹膜透析(CAPD)患者腹膜电荷屏障,并对原发病为糖尿病肾病(DN)与慢性肾炎(CGN)的CAPD患者的腹膜电荷屏障以及透析液蛋白进行比较,进而探讨CAPD患者腹膜电荷屏障与透析液蛋白丢失的相关性。方法:选择32例CAPD患者,收集血清以及透析液,采用清除法测定胰淀粉酶清除率(Cpam)以及唾液淀粉酶的清除率(Csam)的比值(Cpam/Csam)用以评价腹膜电荷屏障;同时测定PD液蛋白的丢失量。比较原发病为DN与CGN两组CAPD患者患者PD液蛋白丢失量以及Cpam/Csam比值。最后,研究腹膜电荷屏障与PD液蛋白丢失量的相关性。结果:(1)32例CAPD患者腹膜Cpam/Csam的比值为6.296±21.514;PD液蛋白为(4.14±1.91)g;(2)CGN组PD液蛋白显著低于DN组(4.35±1.88gvs5.61±0.86g,P<0.05);而CGN组Cpam/Csam的比值显著高于DN组(9.94±28.35vs0.68±0.86,P<0.05)。(3)所有患者Cpam/Csam与PD液蛋白丢失量之间具有显著负相关,相关系数为-0.584,P<0.01。而且其自然对数与PD液蛋白丢失量呈直线负相关。结论:腹膜电荷屏障损害在CAPD患者PD液蛋白丢失起重要作用;电荷屏障损害越显著,PD液蛋白的丢失量越多,提示改善腹膜电荷屏障电荷特性可成为防止腹膜蛋白质丢失的一个重要手段。Objective：To determine the charge barrier of continous ambulatory peritoneal dialysis （CAPD） patient,and compare the charge barrier and peritoneal protein loss of diabetic nephropathy （DN） group with chronic glomerulonephritis （CGN） group. In addition, the correlation of charge barrier and protein loss has also been investigated. Methodology：The blood sample and peritoneal fluid were collected, and then peritoneal charge barrier was mesured by defferential clearance of isoamylase （Cpam/Csam）. The protein loss of peritoneal fluid was also determined. And same time, Cpam/Csam and the protein of the CGN group and DN group with CAPD were compared respectively. At last, the correralation of Cpam/Csam and the protein loss was analysised. Results： （ 1 ） Peritoneal Cpam/Csam of these 32 patients was 6. 29 ±21.5 and the protein loss of peritoneal fluid was （4. 14 ± 1.91 ） g. （2）The peritoneal protein of DN group was significantly higher than that of CGN group [ （4. 35 ± 1.88） g vs （5.61 ±0. 86） g,P 〈0.05 ]. While the charge barrier of DN group was significantly lower than that of CGN group [ （9.94 ±28.4） vs （0. 68 ±0. 86） ,P 〈0. 05）. （3） Cpam/Csam was negative correlated with the protein loss （r = -0. 584, P 〈0. 01 ） , and the natural logarithm of Cpam/Csam was also linear correlated with the latter. Conclusion ： Loss of the peritoneal charge barrier may play a role in the peritoneal protein loss of CAPD patients, the more charge has lost, the more of the peritoneal protein lost. It suggests that improving charge barrier status may be an important way to decrease the protein loss of CAPD patients.

关 键 词：腹膜透析 电荷屏障 淀粉酶 

分 类 号：R692[医药卫生—泌尿科学]