腹膜透析超滤衰竭患者腹膜组织中碱性成纤维生长因子检测

Detection of basic fibroblast growth factor in the peritoneum of peritoneal dialysis patients with ultrafiltration failure

目的:检测腹膜透析超滤衰竭患者腹膜组织中碱性成纤维生长因子(bFGF)的表达,并探讨其可能的作用机制。方法:取8名正常对照者、12名尿毒症非透析患者以及10名腹透患者的腹膜活检标本,行RT-PCR、免疫组化染色检测bFGFmRNA和蛋白表达,行CD34染色计数腹膜组织微血管密度(MVD)。结果:bFGF在各组腹膜组织均有表达,尿毒症非透析组、腹透组mRNA水平和蛋白表达水平均较正常组升高[mRNA:(0.63±0.02),(0.74±0.02)vs(0.46±0.02);蛋白:(116.4±1.8),(143.0±2.4)vs(96.2±1.4)],且腹透组升高更为明显,差异有统计学意义(F分别为75.526和62.090,P均<0.001);3组腹膜MVD依次为(3.05±0.45)、(5.98±0.47)vs(9.62±0.49),差异有统计学意义(F=30.452,P<0.001),与正常组相比,尿毒症非透析组MVD计数增加,腹透组腹膜组织MVD计数最多。结论:腹透患者腹膜组织中bFGF表达升高,可能参与长期透析所致腹膜组织新生微血管形成过程。

Aim：To investigate the expression of basic fibroblast growth factor（bFGF） in the peritoneum of peritoneal dialysis（PD） patients with ultrafiltration failure and the possible mechanism.Methods：Peritoneal biopsies were obtained from normal subjects（n=8）, uremic predialysis patients（n=12） at catheter insertion and PD patients（n=10） at the time of catheter remove,reinsertion or renal transplantation. Immunohistochemical staining and RT-PCR techniques were used to investigate bFGF expression in peritoneal tissue. Microvessel density （MVD） of peritoneal tissue was assessed using immunohistochemistry with CD34 monoclonal antibody.Results：All peritoneal samples expressed bFGF at both protein and mRNA level. Compared with normal group, bFGF mRNA and protein expression in uremic predialysis and PD groups were significantly up-regulated [（0.63±0.02）,（0.74±0.02） vs （0.46±0.02）;（116.4±1.8）,（143.0±2.4） vs （96.2±1.4）,F=75.526 and 62.090,P0.001）]. MVD was up-regulated in uremic predialysis and PD groups compared with normal group[（5.98±0.47）,（9.62±0.49） vs （3.05±0.45）,F=30.452,P0.001],especially in PD group.Conclusion： Uremia circumstances and non-physiological compatibility of peritoneal dialysis liquid might increase bFGF,which might play a role in neoangiogenesis of peritoneum.