动静脉内瘘成形术中肝素对髓过氧化物酶水平的影响研究

Impact of Heparin on Myeloperoxidase Levels During Process of Arteriovenous Fistula Formation

目的探讨尿毒症患者动静脉内瘘成形术过程中肝素对血浆髓过氧化物酶(MPO)水平的影响。方法收集2011年1月—2013年6月潍坊市人民医院血液透析中心首次行动静脉内瘘成形术患者31例,分别采用酶联免疫吸附试验(ELISA法)和免疫比浊法检测注入肝素前及注入肝素后0.5、2.0 h时的血浆MPO水平和血清超敏C反应蛋白(hs-CRP)水平。结果注入肝素前及注入肝素后0.5、2.0 h血浆MPO水平比较,差异有统计学意义(F=11.654,P<0.05)。注入肝素后0.5 h血浆MPO水平高于注入肝素前(P<0.05);注入肝素后2.0 h血浆MPO水平与注入肝素前比较,差异无统计学意义(P>0.05);注入肝素后2.0 h血浆MPO水平低于注入肝素后0.5 h(P<0.05)。注入肝素前及注入肝素后0.5、2.0 h血清hs-CRP水平比较,差异无统计学意义(F=0.074,P>0.05)。结论尿毒症患者动静脉内瘘成形术过程中体内血浆MPO水平可出现一过性升高,但hs-CRP水平无明显变化,可能由肝素刺激血管壁使MPO释放引起,为临床进一步研究提供了参考依据。

Objective To explore the impact of heparin on plasma myeloperoxidase（ MPO） levels during the process of arteriovenous fistula formation in uremic patients. Methods From January 2011 to June 2013,in the hematodialysis center of Weifang People’s Hospital,the levels of plasma MPO and serum high- sensitivity C- reactive protein（ hs- CRP） were determined by enzyme- linked immunosorbent assay（ ELISA） and immunoturbidimetry（ ITM） in 31 uremic patients who had arteriovenous fistula formation for the first time before heparin injection,at hours 0. 5,2. 0 after. Results There was significant difference among plasma MPO levels before heparin,at hours 0. 5,2. 0 after heparin（ F = 11. 654,P 〈 0. 05）. MPO was higher at 0. 5 h after heparin than before（ P 〈 0. 05）,there was no difference between MPO levels before heparin and at 2. 0 h after（ P 〉 0. 05）,lower at 2. 0 h after heparin than at 0. 5 h（ P 〈 0. 05）. There was no difference among serum hs- CRP levels before heparin,at hours 0. 5,2. 0 after（ F = 0. 074,P 〉 0. 05）. Conclusion In uremic patients,plasma MPO level increases transiently during the process of arteriovenous fistula formation,but hs- CRP level does not change obviously,which may be caused by heparin stimulating vessel walls to release MPO.