腹透液CA125水平与腹膜转运的关系

Dialysate CA125 and Possible Relationship with Peritoneal Transport in Peritoneal Dialysis Patients

目的探讨腹透患者检测癌抗原125(CA125)的临床意义以及间皮细胞在腹膜转运中的作用。方法采用4.25%葡萄糖浓度的腹透液对34例腹透患者行腹膜平衡试验,于腹透液留腹4h时采集10mL用放免法测定CA125浓度,并用体表面积校正。收集0、1、4h的透析液及1h的血标本,测定肌酐和葡萄糖浓度,记录净超滤量(nUF),计算4h透析液肌酐与血肌酐浓度之比(D/Pcr)、肌酐转运面积系数(MTACcr)、葡萄糖吸收率(Glu%)、1h透析液钠与血钠比值(D/PNa+)等溶质和液体转运参数。结果腹透液CA125平均浓度为(7.39±4.47)U·mL-1·1.73m～2。腹透液CA125水平与患者腹透龄呈显著负相关(P<0.05);与D/PNa+弱正相关(P<0.05);与溶质转运参数D/Pcr、MTACcr、Glu%、nUF不相关。结论动态观察腹透液CA125水平可间接了解腹膜间皮细胞状态。随着腹透治疗时间的延长,腹膜间皮细胞的数量会逐渐减少。腹透时间皮细胞不是溶质转运的一道重要滤过屏障。

Objective To investigate the clinical significance of dialysate CA125 concentrations and its possible relation to peritoneal transport in peritoneal dialysis (PD) patients. Methods We determined dialysate CA125 levels in 34 stable PD patients. All examinations were done during 4 h dwell with 4.25% glucose. Mass transfer area coefficient of creatinine (MTACcr) was calculated according to Garred model. Creatinine D/P concentration ratio (D/Pcr) , glucose absorption rate (Glu% ) and net ultrafiltration (nUF) were also assessed. Sodium sieving (D/PNa+ ) was determined to be used as a reflection of transcellular water transport. Results The mean dialysate CA125 concentration was(7.39±4.47 ) U·mL-1 ·1. 73 m-2. The dialysate CA125 level was reversely correlated with the duration of PD treatment (P <0. 05) and weakly correlated with D/PNa+ (P <0. 05). No relationship was present with all the transport parameters including MTACcr, creatinine D/P, glucose absorption rate and net ultrafiltration. Conclusion Longitudinal follow-up of dialysate CA125 can reflect mesothelial cell mass and turn-over. Mesothelial cell mass is negatively related to the duration of PD treatment; the mesothelium is not an important solute transport barrier during PD.