容量超负荷治疗前后多糖蛋白包被浓度变化  

Changes of endothelial glycocalyx concentration before and after volume overload therapy

作　　者：宋慧敏 王静[1] 饶歆[1] 李建国[1] SONG Huimin;WANG Jing;RAO Xin;LI Jianguo(Zhongnan Hospital of Wuhan University,Wuhan 430071,China)

机构地区：[1]武汉大学中南医院

出　　处：《公共卫生与预防医学》2019年第4期42-45,共4页Journal of Public Health and Preventive Medicine

基　　金：国家自然科学基金(胆碱能抗炎通路对脓毒症血小板活化及炎性反应的影响:8157946);湖北省基金(胆碱能抗炎通路拮抗兔粥样硬化斑块炎性反应机制研究:WJ2017M041)

摘　　要：目的观察容量超负荷治疗前后多糖蛋白包被浓度的变化。方法纳入2018年6月至2018年12月诊断为容量超负荷的患者,容量超负荷减轻前后留取动脉血,检测透明质酸(HA)、蛋白聚糖-1(Syn-1)、硫酸乙酰胺肝素(HS)、硫酸软骨素(CS),同时比较治疗前后症状和体征的变化。结果57例患者纳入此研究,按容量超负荷程度分为A组(<2000mL)、B组(2000~4000mL)、C组(>4000mL),结果C组HA、Syn-1浓度最高,分别为(5.65±0.84)、(479.44±56.93)ng/mL,与其他组比较P<0.05。容量负荷减轻前后HA分别为(4.62±0.81)、(1.64±0.53)ng/mL,P=0.034;Syn-1分别为(369.85±79.26)、(169.11±44.47)ng/mL,P=0.021;HS,CS治疗前后差异无统计学意义。按照液体清除的量分为a组(1000~2000mL),b组(2000~3000mL),c组(3000~4000mL),c组HA、Syn-1下降最明显。治疗后除胸腔积液外其它容量超负荷临床症状的患者人数显著减少,P<0.05。结论容量超负荷患者多糖蛋白包被受到损害,并且负荷越重,损伤越严重;减轻容量负荷后,多糖蛋白包被有不同程度的恢复。Objective To observe the changes of endothelial glycocalyx concentration before and after volume overload treatment. Methods Patients diagnosed with volume overload from June 2018 to December 2018 were included. Arterial blood was collected before and after volume overload therapy. Hyaluronic acid (HA), syndecan-1(Syn-1), heparan sulfate(HS), and chondroitin sulfate (CS) were detected, while comparing changes in symptoms and signs before and after treatment. Results A total of 57 patients were enrolled in this study. Based on volume overload level, they were divided into group A(<2 000mL), group B(2 000~4 000mL) and group C(>4 000mL). The concentrations of HA and Syn-1, 5.65 ±0.84 ng/mL and 479.44 ±56.93 ng/mL, respectively, in group C were the highest among all three groups( P <0.05). HA and Syn-1 decreased significantly after therapy of volume overload. Before and after treatment, HA was 4.62±0.81, 1.64±0.53 ng/mL ( P =0.034), and Syn-1 was 369.85±79.26, 169.11± 44.47 ng/mL ( P = 0.021). There was no significant difference in HS and CS between before and after treatment. According to the amount of liquid clearance, it was divided into group a (1 000~2 000mL), group b (2 000~3 000mL) and group c(3 000~4 000mL). The decrease of HA and Syn-1 in group c was the most obvious. The number of patients with clinical symptoms of volume overload after treatment decreased significantly, P <0.05. Conclusion In patients with volume overload, the endothelial glycocalyx was damaged, and the heavier the load, the more serious the damage. After volume overload therapy, the endothelial glycocalyx showed different degrees of recovery.

关 键 词：多糖蛋白包被 容量超负荷治疗 透明质酸 蛋白聚糖-1 

分 类 号：R11[医药卫生—公共卫生与预防医学] R543