维持性血液透析患者血浆转化生长因子β1检测及其临床意义

DETERMINATION OF TRANSFORMING GROWTH FACTOR β1 PLASMA LEVEL AND ITS CLINICAL SIGNIFICANCE IN MAINTENANCE HEMODIALYSIS PATIENTS

目的 :检测维持性血液透析 (MHD)治疗患者血浆TGFβ1水平并探讨其可能的临床意义。方法 :应用竞争性酶联免疫法 (ELISA)测定 2 7例MHD患者和 2 0例健康对照者血浆TGFβ1水平。结果 :与正常对照组相比 ,MHD患者血浆TGFβ1水平明显增加 (82 .9± 9.8比 5 0 .2± 5 .7)ng/ml(P <0 .0 1)。但血浆TGFβ1水平与血Hct无明显相关关系 (r=0 .15 2 ,P >0 .0 5 )。另外 ,患者血浆TGFβ1水平与接受rHuEPO治疗的剂量之间亦无明显相关性。将MHD患者按血浆iPTH水平现再分小于和大于 2 0 0 pg/ml两组 ,发现两组间血浆TGFβ1水平有明显统计学差异 (72 .1± 4.6比 93.7± 6 .5 ) pg/ml(P <0 .0 5 ) ,但所有MHD患者血浆TGFβ1与iPTH水平之间无明显相关性 (r=0 .2 5 7,P >0 .0 5 )。结论 :MHD患者TGFβ1水平增加可能参与许多不利因素的发生 ,特别与继发甲状旁腺机能亢进关系密切。

Objective:To determine transforming growth factor β1 plasma lever and investigate its clinical significance in maintenance hemodialysis (MHD) patients.Methods:The plasma level of TGFβ1 was measured by a solid phase ELISA in 27 uremic patients undergoing MHD,20 healthy control subjects.Results:Compared with controls,the patients on MHD had significantly higher mean TGFβ1 level (82.9±9.8 vs 50.2±5.7ng/ml,P<0.01).However,the mean plasma level of TGFβ1 was not correlated with the hematocrit (Hct)(r=0.152,P>0.05).Similarly,no correlation was observed between the plasma level of TGFβ1 and the dose of erythropoietin (EPO) administered.The patients undergoing MHD were divided into two groups according to the serum level of iPTH.Plasma level of TGFβ1 in patients with iPTH than 200pg/ml was significantly higher than that lower than 200pg/ml (72.1±4.6 vs 93.7±6.5pg/ml,P<0.05).Nevertheless,there was no correlation between serum iPTH and the plasma level of TGF β1 (r=0.257,P>0.05).Conclusions:Our results show than MHD is associated with the increased the plasma level of TGFβ1.Specifically,the patients with secondary hyperparathyrodism (SHP) have more higher the plasma level of TGFβ1 than without SHP.