尿毒症透析患者糖化产物的测定及意义

Observation of the glycation products in the patients on dialysis

目的 :探讨蛋白质非酶糖化的早期产物Amadori及糖化终末产物AGEs在非糖尿病尿毒症透析患者血清中的浓度变化及透析的清除效果。方法 :用氯化硝基四氮唑蓝法分别测定 2 0例血液透析 (HD)患者、17例腹膜透析 (CAPD)患者和 2 1例健康对照者的果糖胺 ,用荧光分光光度计分别测定上述三组的糖化终末产物 (AGEs) ,对其结果进行统计学分析。结果 :HD组与CAPD组的果糖胺水平比正常组增高 ,差异有显著性 (P <0 0 1) ,而透析组之间无差异 (P >0 0 5 ) ,血清AGEs3组之间两两均有差异 (P <0 0 1)。比较一次血透前后果糖胺透前透后无差异 (P >0 0 5 ) ,AGEs透前透后有显著性差异 (P <0 0 1) ,但AGEs透后只降低了 2 1.42 %。结论 :提示糖化产物在尿毒症患者产生增多而排泌减少 ,透析治疗不能很好地清除。

Objective :To explore the relationship between the early glycation products(fructosamine)and the advanced glycation end-products(AGEs) in the patients on dialysis.And to study the effect of dialysis on removing glycation products.Methods: Levels of plasma fructosamine and AGEs were mesured in 20 Patients on hemodialysis(HD).The same Procedure were compared with those in 17 patients on continuous ambulatory peritoneal dialysis(CAPD) and 21 control subjects.Results: Levels of plasma fructosamine and AGEs in Patients on HD(P<0 01) and CAPD (P<0 01)were significant ly higheras compared with those in control subjects,but fructosamine was not different between the HD group and the CAPD group (P>0 05).Fructosamine dose not change before and after hemodialysis (P>0 05).But the AGEs level was significantly different between the two groups (P<0 01).Conclusion:It is shown that fructosamine and AGEs were significantly higher in patients on dialysis,and they could not be effectively removed by dialysis.