腹膜透析对腹腔巨噬细胞产生一氧化氮的影响  

EFFECTS OF PERITONEAL DIALYSIS ON MACROPHAGE NITRIC OXIDE PRODUCTION AND ITS RELATION WITH PERITONEAL LYMPHATIC STOMATA

作　　者：李继承[1] 张凯[2] 杨泽然[1] 

机构地区：[1]浙江大学医学院淋巴学研究室,杭州310006 [2]杭州红十字会医院肾内科

出　　处：《肾脏病与透析肾移植杂志》2000年第1期13-17,共5页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金!(NO .39970 381 )

摘　　要：目的 :研究腹膜透析 (PD)对巨噬细胞产生一氧化氮 (nitricoxide,NO)和腹膜淋巴孔的影响 ,探讨PD失超滤机制。　 方法 :①应用Baxter腹透液建立PD小鼠模型 ;②用全自动酶标仪动态测定NO量 ;③用扫描电镜观察不同时间点腹膜间皮超微病理变化 ;④使用计算机与扫描电镜联机的图像处理系统 ,测定不同PD时间点腹膜淋巴孔的改变。　 结果 :随着PD进行 ,大量巨噬细胞经腹膜淋巴孔游出 ,进入腹腔形成乳斑。NO浓度逐渐增高 ,间皮细胞损伤趋严重 ,腹膜淋巴孔孔径增大、分布密度增高。停止PD ,乳斑减少 ,NO量逐渐降低 ,损伤的间皮细胞开始修复 ,腹膜淋巴孔渐趋正常。至停止PD 40天 ,间皮细胞基本修复 ,腹膜淋巴孔恢复正常。　 结论 :PD使大量巨噬细胞进入腹腔 ,巨噬细胞产生的高浓度NO可损害间皮细胞、舒张腹膜淋巴孔 ,可能与腹透液吸收增加 ,PD失超滤有关。Long term peritoneal dialysis inevitably leads to ultrafiltration failure.An animal model was established to study the mechanism of ultrafiltration failure in peritoneal dialysis by analyzing nitric oxide(NO) regulation of peritoneal lymphatics stomata and lymph reabsorption form the peritoneal cavity. METHODOLOGY ①The animal model of peritoneal dialysis was established with the application of Baxter dialysate; ②Dynamic NO measurements were performed during peritoneal dialysis and its cessation; ③Sequential observation of ultra structural changes in peritoneal mesothelium was made under scanning electron microscope(SEM)at different length of dialysis time; ④Dynamic changes in the peritoneal lymphatic stomata were studied by computer image processing system. RESULTS Numerous macrophages were found to enter peritoneal cavity to form milky spot.Damages of mesothelial cells,increased density of their distribution and enlargement of the peritoneal lymphatic stomata were found to be associated with the increase in macrophage NO quantity during the experiment.The mesothelium damage amelioration and the peritoneal lymphatic stomata recovery were observed with the decreasing NO quantity in peritoneal dialysate.Complete recovery of mesothelium and the peritoneal lymphatic stomata were observed in this model in 40 days after the cessation of peritoneal dialysis. CONCLUSION In long term peritoneal dialysis,increased peritoneal macrophages is associated with increased NO production,which might damage mesothelium and relax lymphatic stomata leading to the enhanced lymph absorption or ultrafiltration failure.

关 键 词：腹膜透析 一氧化氮 腹膜淋巴孔 

分 类 号：R459.5[医药卫生—治疗学]