维持血液透析患者血清肿瘤坏死因子α的测定及意义

Detection of Tumor Necrosis Factor α in Maintaining Hemodialysis Patients

目的比较维持血液透析患者和正常健康人血清中肿瘤坏死因子α(TNF-α)浓度的差异,探讨TNF-α在维持血液透析患者的意义。方法采用酶联免疫吸附法测定40名维持血液透析患者和40名正常健康成人血清中TNF-α的浓度,同时测定所有研究对象的血清尿素氮(BUN)、肌酐(CREA)、尿酸(UA)、超敏C反应蛋白(hs-CRP)及血清胱氨酸蛋白酶抑制剂C(Cyst C),并用统计学方法对其数据进行分析。结果维持血液透析患者血清TNF-α水平(23.02±0.22)pg/ml明显高于健康对照组(10.16±1.19)pg/ml,差异有统计学意义(P<0.01)。CRP、BUN、CREA、UA和Cyst C也较健康对照组显著升高(P<0.01)。相关性分析结果显示维持血液透析患者血清中TNF-α与BUN(r=0.43,P<0.05),CREA(r=0.79,P<0.01)呈正相关且差异有统计学意义,但与CRP(r=0.13)、Cyst C(r=0.26)、UA(r=0.01)无相关性。结论 TNF-α是维持血液透析患者的一个重要炎症介质,且联合BUN和CRE的测定可以监测其病情。

Objective To compare the concentrations of serum tumor necrosis factor（TNF-α） in maintaining hemodialysis patients and healthy adults for evaluating the significance of detection of TNF-α in hemodialysis patients.Methods The concentrations of TNF-α in 40 hemodialysis patients and 40 healthy adults were detected and analyzed by ELISA.Furthermore,the concentrations of blood urea nitrogen（BUN）,creatinine（CREA）,uric acid（UA）,ultra-sensitive C-reactive protein（hs-CRP） and Cystatin C（Cyst C） were also detected.Finally,these data were analyzed using statistical methods.Results The concentration of TNF-α in hemodialysis patients was significantly higher than that in healthy control group（23.02±0.22 pg/ml vs 10.16±1.19 pg/ml）,and the difference was statistically significant（P0.01）.The concentration of hs-CRP,BUN,CREA,UA,and Cyst C in hemodialysis patients were also significantly higher than those in healthy control group（P0.01）.The results of correlation analysis showed that TNF-α in hemodialysis patients was positively correlated with BUN（r=0.43,P0.05） and CREA（r=0.79,P0.01）,respectively.But there was no correlation between TNF-α and hs-CRP（r=0.13,P0.05）,TNF-α and Cyst C（r=0.26,P0.05）,TNF-α and UA（r=0.01,P0.05）.Conclusions TNF-α is an important inflammatory mediator to hemolysis patients,and could be united with BUN and CREA to monitor the patient＇s condition.