不同通量血液透析对血管内皮细胞生长因子及白细胞介素1β水平的影响  

Effect of high and low flux hemodialysis on vascular endothelial cell growth factor and interleukin-1 beta levels in maintenance hemodialysis patients

作　　者：王文政[1] 张金平[2] 王佳[2] 杨晓萍[2] 

机构地区：[1]石河子大学医学院,石河子832002 [2]石河子大学医学院附属第一医院,石河子832008

出　　处：《临床肾脏病杂志》2015年第5期268-271,共4页Journal Of Clinical Nephrology

摘　　要：目的探讨不同透析方式对维持性血液透析（maintainance hemodialysis，MHD）患者血管内皮细胞生长因子（vascular endothelial growth factor，VEGF）及白细胞介素1β（interleukin-1，IL-1β）水平的影响，为合理的透析方式选择、改善血液透析患者预后提供理论依据。方法收集2012年6月至2014年6月在新疆石河子大学第一附属医院血液净化中心行MHD患者32例，其中高通量血液透析（high flux hemodialysis，HFHD）组16例，低通量血液透析（low flux hemodialysis，LFHD）组16例，另选择16名体检健康的志愿者设为对照组。检测3组相关生化指标，用EusA法检测血浆VEGF及IL-1β。结果与对照组相比，MHD患者血浆VEGF水平显著偏高，差异有统计学意义（P〈0．05），HFHD组与LFHD组比较血浆VEGF水平偏低，差异有统计学意义（P〈0．05）；进一步行单因素相关性分析显示血浆VEGF水平与透析时间、全段甲状旁腺素（immunoreactive parathyroid hormone，iPTH）、低密度脂蛋白呈正相关（r=0．65、0．605、0．284，P〈0．05）。与对照组相比，MHD患者血浆IL-1β显著偏高，差异有统计学意义（P〈0．05）；HFHD组与LFHD组比较血浆IL-1β水平偏低，差异有统计学意义（P〈0．05）进一步行单因素相关性分析显示血浆IL-1β与年龄呈负相关（r=-0．261，P〈0．05），与低密度脂蛋白、透析时间、iPTH、VEGF呈正相关（r=0．274、0．722、0．658、0．783，P〈0．01）。单因素相关性分析显示血浆VEGF与IL-1β水平呈正相关（r=0．783，P〈0．01）。结论与LFHD比较，HFHD可更加有效的减轻MHD患者微炎症状态、保护其血管内皮功能，改善患者预后。Objective To invesigate the effects of the different dialysis procedures on vascular endothelial growth factor （VEGF） and interleukin-1 beta （IL-1β） levels in maintenance hemodialysis （MHD） patients to provide a theoretical basis for a reasonable choice for dialysis, and for improving the prognosis of patients with hemodialysis. Methods From June 2012 to June 2014 in the Blood Puri- fication Center of the First Affiliated Hospital of Shihezi University, 32 patients with MHD were se- lected, including high flux hemodialysis group of 16 cases, and low flux hemodialysis group of 16 ca- ses. The 16 healthy volunteers served as control group. Related biochemical indexes were determined, and ELISA was used to detect the plasma levels of VEGF and IL-113. Results As compared with con- trol group, the plasma VEGF level in patients with MHD was significantly increased （P^0. 05）, and that in HFHD group was significantly lower than in LFHD group （P^0. 05）. The single factor corre- lation analysis showed that plasma VEGF level was positively correlated with dialysis age, intact parathyroid hormone （iPTH）, and low density lipoprotein （r= 0. 65, 0. 605, and 0. 284, P〈0. 05）. As compared with control group, plasma IL-1β was significantly increased, and that was statistically re- duced in HFHD group as compared with LFHD group （P〈0. 05）. The single factor correlation analysis showed there was a negative correlation between IL-1β and age （r = -0. 261, P〈0. 05）, but a positive correlation between IL-1β with low density lipoprotein, dialysis age, iPTH and VEGF （r = 0. 274, 0. 722, 0. 658, and 0. 783, P〈0. 01）. Single factor correlation analysis showed that plasma VEGF and IL-1β levels showed a positive correlation （r = 0. 783, P〈0. 01）. Conclusions As compared with LFHD, HFHD can reduce micro-inflammatory state in MHD patients and protect endothelial function more effectively, and improve the prognosis of patients.

关 键 词：微炎症状态 高通量血液透析 低通量血液透析 血管内皮细胞生长因子 白细胞介素1Β 

分 类 号：R692.5[医药卫生—泌尿科学]