首次透析患者血浆髓过氧化物酶与血清超敏C反应蛋白水平的变化

Research on MPO and hs-CRP level changes in first time hemodialysis patients

目的探讨首次血液透析(hemodialysis,HD)患者透析前、透析中、透析后血浆髓过氧化物酶(MPO)和血清超敏C反应蛋白(hs-CRP)水平的变化,分析其可能的原因及意义。方法收集28例首次HD患者透析前、透析中(HD0.5 h)、透析后(HD 3.0 h)血标本各4 ml,其中2 ml置于乙二胺四乙酸抗凝管,2 ml置于普通试管,低温离心后分别收集血浆和血清。分别采用酶联免疫吸附试验(ELISA法)和免疫比浊法检测血浆MPO和血清hs-CRP水平。比较透析前、透析中、透析后MPO和hs-CRP水平的变化。结果透析中与透析前比较MPO水平明显升高(P<0.05),透析后分别与透析前和透析中比较MPO水平无明显变化(P>0.05)。透析过程中hs-CRP水平无显著变化(P>0.05)。结论首次透析可引起患者体内MPO水平一过性升高,但对患者hs-CRP水平无明显影响。提示首次透析引起的一过性MPO升高很可能是由于透析过程中使用的肝素刺激血管壁固化MPO释放引起。

Objective To investigate the level of plasma myeloperoxidase（MPO） and high-sensitivity C reactive protein（hs-CRP） before dialysis,during dialysis and after dialysis of the patients with first time hemodialysis and to analyze the possible causes and significance.Methods Each 4 ml of blood sample before dialysis,during dialysis（HD 0.5 h） and after dialysis（HD 3.0 h） was collected from 28 cases of first time hemodialysis.In 4 ml of blood sample,2 ml was placed in EDTA anticoagulant tubes and the remaining 2 ml was put in ordinary test tube.After low-temperature centrifugation,plasma and serum were collected respectively.Plasma MPO and serum hs-CRP levels were respectively assayed by ELISA and immunonephelometry for comparing the changes before dialysis,duing dialysis and after dialysis.Results Comparing intradialysis with the pre-dialysis,the levels of MPO were significantly increased（P0.05）.Comparing post-dialysis with pre-dialysis and intradialysis,the levels of MPO had no significantly change（P0.05）.The hs-CRP levels had no significant change during dialysis（P0.05）.Conclusions First time dialysis can cause the transient increase of MPO level,but has no apparent influence on the hs-CRP level.This suggests that the transient elevated MPO level is probably caused by the release of blood vessel-wall MPO stimulated by heparin.