透析膜对血液透析患者外周血转化生长因子β1及单核细胞趋化蛋白-1水平的影响

Effects of dialyzed membrane on TGF-β1 and MCP-1 plasma levels in hemodialysis patients

目的研究不同透析膜对维持性血液透析（ＭＨＤ）患者外周血转化生长因子β１（ＴＧＦ－β１）及单核细胞趋化蛋白－ｌ（ＭＣＰ－１）水平的影响。方法应用酶联免疫法（ＥＬＩＳＡ）测定长期用铜仿膜（ＣＵ）和聚砜膜（ＰＳＵ）透析患者外周血 ＴＧＦ－β１及 ＭＣＰ－１水平。结果与正常对照组［（５０ ２ ±５． ７） ｎｇ／ｍｌ］相比，ＣＵ［（８２． ９ ± ９．８）ｎｇ／ｍ］和 ＰＳＵ［（６５． ５ ± ９． ２）ｎｇ／ｍｌ］透析患者外周血 ＴＧＦ－β１水平明显增加（Ｐ＜０．０１，Ｐ＜０．０５），但ＰＳＵ组与ＣＵ组相比，外周血ＴＧＦ－β１水平明显下降（Ｐ＜０． ０５）。 ＭＨＤ患者外周血 ＭＣＰ－１水平也有所增加，其中 ＰＳＵ组［（７２． ２± ５． ３） ｐｇ／ｍｌ］与对照组［（５６．４±７．８）ｎｇ／ｍｌ］相比有显著性差异（Ｐ＜０．０５）。另外，ＣＵ与ＰＳＵ组内ＴＧＦ－β１与ＭＣＰ－１水平之间均呈明显负相关（ｒ＝－０．５４２５与－０．４５６２，Ｐ均＜０．０５）。结论ＭＨＤ可增加尿毒症患者ＴＧＦ－β１与ＭＣＰ－１水平，但透析膜类型对它们的影响有所不同。

Objective To investigate effects of different dialyzed membrane on transforming growth factor(TGF-β1 ) and monocyte chemoattractant protein(MCP-1 ) plasma levels in maintenance hemodialysis (MHD) patients. Methods The plasma concentrations of TGF-β1 and MCP-1 were measured by ELISA assay in well-matched uremic patients undergoing maintenance hemodialysis with either cuprophane (CU, n = 27 ) or polysulfone (PSU, n = 25 ). Results Compared with controls (50. 2 ± 5. 7 ng/ml), the patients on CU(82. 9 ± 9. 8 ng/ml) and PSU (65. 5 ± 6. 5 ng/ml)membranes dialysis had significantly higher mean TGF-β1 concentration (P < 0. 01, P < 0. 05). However, the patients on PSU membrane dialysis had significantly lower mean TGF-β1 concentrations in contrast with CU membrane dialysis. MCP-1 plasma levels were also higher in patients dialyzed with PSU(72. 2 ± 5. 3 pg/ml) than in controls(56. 4 ± 7. 8). In contrast to TGF-β1, the increase was greater in PSU-treated patients than in CU-theated patients. In addition, negative correlation was observed between the plasma levels of TGF-β1 and MCP-1 in patients dialyzed with CU or PSU. Conclusions MHD is associated with the increase of plasma levels of TGF-β1 and MCP-1. Moreover, the type of dialysis membrane has different effects on plasma levels of TGF-β1 and MCP- 1.