腹膜透析液中钙对持续性不卧床腹膜透析患者腹膜间皮细胞的影响

Effect of Calcium in PDF on CAPD Patient'peritoneal Mesothelial Cell

【目的】探讨腹膜透析液(PDS)中不同浓度钙对体内腹膜间皮细胞(HPMCs)损伤、增殖及间质纤维化的影响。【方法】选择规律性腹膜透析治疗的终末期肾功能衰竭患者30例,既往使用PD4(钙浓度1.25mmol/L)透析,作为对照组。改用标准钙透析液(钙浓度1.75 mmol/L)透析4周,每周末作为一个实验组。期间每周末检测腹透引流液中纤维连接蛋白(FN)、CA125、LDH,同时测定血磷、钙、甲状旁腺激素水平变化情况。【结果】换用标准钙透析液治疗后,与对照组相比,腹透引流液中LDH水平随作用时间延长呈上升趋势(P<0.01),第4周CA125、FN浓度值明显降低(P<0.05),血钙浓度显著升高,磷、PTH浓度差异无显著性。【结论】生理钙PDS与标准钙PDS相比,可抑制HPMCs增殖、损伤HPMCs及促进FN合成,能保护腹膜功能并一定程度延缓腹膜纤维化进程。

[Objective]To observe the effect of various concentration calcium on vivo HPMs proliferation, damnification and interstitial fibrosis. [Methods]Thirty regular CAPD patients suffered from end-stage renal failure were selected. Previously they used Baxter PD4（with calcium concentration 1.25mmol/L）,which were adopted as control group, changed using standard-calcium dialysate （with calcium concentration 1.75mmol/L） for 4 weeks, each weekend was one experimental group. During the period, detected the level of FN, CA125, LDH in peritoneal effluent. Simultaneous determine the variation of level of serumal phosphonium, calcium and PTH. [Results]These patients had taken the examinations such as ultrasonography , gastroscopy, PTC, ERCP,CT scan. All cases were cured. [Conclusion]There are some characters in ultrasound of biliary-duodenal fistula. Biliary pneumatosis was clewed biliary-duodenal fistula. The following situations suggest the diagnosis. Gallstone found places other than formerly confirmed, Abnormal contrast medium or bile fluxion found in gastroscopy or PTC. The gallbladder must be carefully checked plays an important practical role in the clinical diagnosis Selecting suitable time of operation and correct treatment have great influence on improvement of treatment results.