蛋白结合尿毒症毒素及其清除技术的研究进展

Progress of the Protein-bound Uremic Toxins and Removal Techniques

尿毒症毒素是一大组体内代谢的产物,在肾功能衰竭患者体液中水平明显升高,并与尿毒症毒素代谢紊乱或临床表现密切相关。部分毒素可与蛋白结合,形成大分子复合物,称为蛋白结合毒素。它们具有多种生物学作用,产生一系列尿毒症并发症,如心血管疾病、免疫功能紊乱、脏器纤维化等。研究发现:血浆分离吸附、高通量血液透析、服用肠道吸附剂等方法可增加蛋白结合毒素的清除。评价尿毒症患者的透析充分性时,也应考虑到蛋白结合毒素。

Uremic toxins are a large group of metabolites, which have significantly higher levels in body fluids of renal failure patients, and are related with toxins metabolic disorders and clinical manifestations closely. Some of them can combine with protein, to form macromolecular complexes, which are called protein-bound uremic toxins. They have a variety of biological effects, to produce a series of uremic complications, such as cardiovascular disease, immune dysfunction, and organ fibrosis. Researchers found that plasma separation adsorption, high-flux hemodialysis, and taking intestinal adsorbents can increase the clearance of protein-bound uremic toxins. While evaluating dialysis adequacy in uremic patients, protein-bound uremic toxins should also be taken into account.