终末糖基化产物在尿毒症患者血清中的水平及血管壁和腹膜上的表达

The serum level of advanced glycosylation end products and its expression in the vascular wall and peritoneum of uremic patients

目的检测终末糖基化产物（ＡＧＥｓ）在尿毒症患者血中的水平及在血管壁和腹膜上的表达及探讨其可能意义。方法用酶联免疫法（ＥＬＩＳＡ）检测尿毒症患者血中ＡＧＥＳ的水平；用免疫组织化学方法在血液透析患者检测其血管壁上ＡＧＥＳ的表达，及腹膜透析患者腹膜上ＡＧＥＳ和层粘蛋白（ｌａｍｉｎｉｎ）的表达。结果尿毒症患者血中ＡＧＥｓ水平明显高于肾功能正常者，且各种透析治疗均不能地降低患者体内ＡＧＥＳ水平。ＡＧＥＳ在血液透析患者血管壁有明显沉积；行腹膜透析一段时间后腹膜ＡＧＥｓ及ｌａｍｉｎｉｎ的表达也明显升高，两者呈明显正相关，且与腹透时间也有相关性。结论血中高浓度的ＡＧＥＳ及其在血管壁的沉积可能与尿毒症患者心血管并发症有关；腹膜透析患者腹膜上ＡＧＥＳ及ｌａｍｉｎｉｎ沉积可能是腹膜硬化及失超滤的原因之一。

Objective To determine the serum level of advanced glycosylation end products (AGEs) of uremia and its expression in the vascular wall and peritoneum of dialysis patient, meanwhile to explore its possible significance. Methods Using the ELISA method to determine the serum level of AGEs of uremia; using immunohistochemical method to examine the expression of AGEs in the vascular wall of uremia patients undergoing hemodialysis and the expression of AGEs and laminin in the peritoneum of uremic patients undergoing peritoneal dialysis. Results The AGEs level of uremic patients was obviously higher than that in the normal. No kind of dialysis could clear it well. AGEs accumulated obviously in the vassular wall of hemodialysis patients. After CAPD the expression of AGEs and laminin in the peritoneum was significantly strong. There was an obviously positive correlation between AGEs and laminin, so between these two and the time of peritoneal dialysis. Conclusions The high serum level of AGEs and its accumulation in the vascular wall may relate with the high incidence of cardic diseases of the uremia. Accumulation of AGEs and laminin in the peritoneum of patients undergoing peritoneal dialysis may be one of the reasons causing peritoneum sclerosis and dysultrafiltration