不卧床持续性腹膜透析患者血浆和透析排出液中细胞因子的变化及意义  

CHANGES OF PLASMA AND DIALYSATE CYTOKINES LEVELS IN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS PATIENTS

作　　者：黄一新[1] 徐琴君[1] 吴亚农[1] 

机构地区：[1]上海市第一人民医院肾内科中心实验室,上海200080

出　　处：《肾脏病与透析肾移植杂志》2000年第2期135-137,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

摘　　要：目的 :研究不卧床持续性腹膜透析 (CAPD)患者血浆和腹膜透析排出液中细胞因子的水平与腹膜透析和机体防御功能的关系。　 方法 :用酶免疫法测定 2 1例非感染期CAPD患者血浆和腹膜透析排出液中IL 1α、IL 1β、IL 6、TNFα、IFNγ和可溶性肿瘤坏死因子受体 1(sTNFR1)水平 ,同时做 4h腹膜平衡试验。比较细胞因子水平与腹透情况和腹膜转运特性的关系 ;另外 ,与同期测定的正常人血浆IL 6和sTNFR1水平作对比研究。　 结果 :2 1例CAPD患者血浆和腹透液中各种细胞因子水平分别为 :IL 1α 34 40± 12 87ng/L和 17 6 0± 10 49ng/L(P <0 0 0 1) ;IL 6 8 10± 14 6 9ng/L和 15 7 6 5± 130 2 3ng/L(P <0 0 0 1) ;TNFα 117 30± 195 2 7ng/L和 2 2 90± 13 37ng/L(P <0 0 5 ) ;sTNFR19 76± 0 98μg/L和 1 84± 2 72 μg/L(P <0 0 0 1)。仅在 8例患者血浆及 9例患者腹透液中检测出IL 1β;在 1例患者血浆中测到IFNγ ,腹透液中IFNγ为 2 14± 0 74kU/L。腹透液中IL 6和IFNγ水平呈负相关 (P <0 0 2 )。血浆和腹透液中各种细胞因子水平与腹透时间长短、既往感染与否、透析充分性和超滤量以及腹膜转运特性均无关系。CAPD患者血浆IL 6和sTNFR1水平比正常人明显升高 (P <0 0 0 1)。　 结论OBJECTIVE To investigate the changes of plasma and peritoneal dialysate effluent(PDE)cytokines and to explore the linkage between the cytokines and defense function in continuous ambulatory peritoneal dialysis(CAPD)patients. METHODOLOGY 21 CAPD patients (non infective stage)were included in this study.The 4 hour peritoneal equilibration test(PET)was performed and cytokines(IL 1α、IL 1β,IL 6,ΤΝFα,INF γ and sTNFR1)were assessed using specific enzyme immunoassays(EIA)in plasma and over night dwell PDE.The levels of cytokines were compared with respect to the state of peritoneal dialysis and the peritoneal membrane transport characteristics.Levels of IL 6 and sTNFRI in plasma were also compared in CAPD patients and in healthy controls. RESULTS The average plasma and PDE levels of IL 1α(34 4±12 87 ng/L;17 60±10 49 ng/L),IL 6(8 10±14 69 ng/L;157 65±130 23 ng/L),TNFα(117 30±195 27 ng/L;22 90±13 37 ng/L)and sTNFRI(9 76±0 98 μg/L;1 84±2 72 μg/L)were determined and compared to that of controls.Plasma IL 1β,plasma INF γ and PDE IL 1β were found undetectable in most of the patients.PDE level of INF γ was 2 14±0 74 kU/L.A negative correlation was found between PDE levels of IL 6 and INFγ.No significant difference was found for each of the cytokines between patients dialyzed over and under 12 months,between patients with and without pervious peritoneal infection,between patients with a weekly KT/V<2 0 and a weekly KT/V>2 0,between patients with high or high average PET and patients with low or low average PET.Plasma levels of IL 6 and sTNFR1 in these CAPD patients were higher than that in normal controls. CONCLUSION The secreted IL 6 and IFN γ in PDE might be involved in the defense mechanism of the peritoneum.The length of dialysis durat

关 键 词：腹膜透析 细胞因子 防御功能 

分 类 号：R459.5[医药卫生—治疗学]