非糖尿病腹膜透析患者血清晚期糖基化终末产物-肽水平影响因素分析  

Analysis of influencing factors of advanced glycation end products peptides in serum in continuous ambulatory peritoneal dialysis non-diabetic patients

作　　者：孙琤[1] 张苗[1] 蒋春明[1] 

机构地区：[1]南京大学医学院附属鼓楼医院肾内科,江苏南京210008

出　　处：《临床荟萃》2009年第6期494-497,共4页Clinical Focus

基　　金：南京市医学科技发展重点项目(ZKX0416)

摘　　要：目的探讨非糖尿病腹膜透析(PD)患者血清晚期糖基化终末产物-肽(AGEs-P)的影响因素。方法应用流动注射分析法(FIA)测定25例稳定的非糖尿病PD患者血清AGEs-P水平,同时测定氧化应激指标谷胱甘肽(GSH)、丙二醛(MDA)含量及总超氧化物歧化酶(T-SOD)活性,炎症指标超敏C反应蛋白(hsCRP)以及生化、透析充分性等指标。应用Pearson相关分析及多元逐步回归分析法分析AGEs-P与相关临床及实验室资料的关系。结果PD患者血清AGEs-P与PD时间、透析葡萄糖剂量、血清hsCRP及血清MDA呈显著正相关(r=0.883、0.901、0.715、0.828,均P<0.01),与残余肾功能、血清GSH、T-SOD呈显著负相关(r=-0.785、-0.817、-0.826,均P<0.01);透析葡萄糖剂量、残余肾功能是影响血清AGEs-P的主要因素(P<0.05)。结论非糖尿病PD患者血清AGEs-P水平与PD时间、透析葡萄糖剂量、残余肾功能、慢性炎症状态及氧化应激状态有关,其中透析葡萄糖剂量、残余肾功能是影响血清AGEs-P水平的关键因素。Objective To investgate the influencing factors of advanced glycation end products peptides（AGEs- P） in serum in continuous ambulatory peritoneal dialysis（CAPD） non-diabetic patients. Methods AGEs-P in serum of 25 CAPD non-diabetic patients was detect by flow injection assay（FIA） ,and the influencing factors,such as duration of CAPD, peritoneal glucose load, KT/V, creatinine clearance rate（CCr） of residual renal and peritoneum, oxidative stress markers such as glutathione （GSH）,total-superoxide dismutase（T-SOD）,malondialdehyde （MDA）,high sensitivity C- reactive protein （hsCRP） were analyzed with multiple stepwise regression analysis and Pearson correlation analysis. Results The concentration of AGEs-P in serum was correlated negatively with residual renal function, GSH,T-SOD concentration （r =-0. 785,-0. 817,-0.826, P 〈0.01） and positively with the duration of CAPD, peritoneal glucose load, hs-CRP, MDA concentration in long-term CAPD non-diabetic patients （ r = 0. 883,0. 901,0. 715,0. 828, P 〈 0.01）. Multiple stepwise regression analysis revealed that peritoneal glucose load and residual renal function were main influencing factors of the concentration of AGEs-P in serum. Conclusion After CAPD, AGEs-P in serum in CAPD non-diabetic patients are correlated with duration of CAPD, peritoneal glucose load, residual renal function, inflammation and oxidative stress, but are influenced mainly by peritoneal glucose load and residual renal function.

关 键 词：肾功能衰竭 慢性 腹膜透析 C反应蛋白质 

分 类 号：R692.5[医药卫生—泌尿科学]