维持性血液透析患者的血清硫化氢水平及其影响因素的分析

Serum Level of Hydrogen Sulfide and Its Influential Factors in Patients Undergoing Maintenance Hemodialysis

目的:研究维持性血液透析患者的血清硫化氢水平及其影响因素。方法:根据筛选及排除标准,纳入符合要求的维持性血液透析患者150例,同时收集健康志愿者17名作为健康对照。留取患者透析前后血标本,健康对照组则清晨空腹抽血。检测血清硫化氢、一氧化氮、一氧化氮/内皮素-1及硫化血红蛋白等水平,并作相关性分析。结果 :维持性血液透析患者透析前血清硫化氢、一氧化氮/内皮素-1比值、硫化血红蛋白水平明显低于健康对照组(P<0.01),而内皮素-1和维生素B6含量与健康对照组差异无统计学意义(P>0.05);透析前血清硫化氢与一氧化氮、一氧化氮/内皮素-1比值、硫化血红蛋白及肾小球滤过率正相关(P<0.01),而与血肌酐水平负相关;透析后血清硫化氢水平较透析前明显上升,一氧化氮水平和一氧化氮/内皮素-1比值明显下降,而内皮素-1、硫化血红蛋白及维生素B6水平在透析前后无明显变化。结论:维持性血液透析患者血清硫化氢水平明显降低,其水平与一氧化氮、硫化血红蛋白、肾功能等显著相关;血液透析后患者血清硫化氢水平较透析前显著升高。

Objective：To investigate the serum level of hydrogen sulfide（H2S）and its influential factors in patients undergoing maintenance hemodialysis（MHD）.Methods：Based on screening and exclusion criteria,150 patients undergoing MHD were enrolled.Meanwhile,17 healthy volunteers were collected as healthy controls.Venous blood samples of MHD patients were obtained before and after dialysis,and fasting blood samples were collected from healthy controls.The levels including serum H2 S,nitric oxide（NO）,endothelin-1（ET-1）,and sulfhemoglobin were detected and the correlations among them were analyzed.Results：The levels of serum H2 S,NO,NO/ET-1 and sulfhemoglobin in patients undergoing MHD were significantly lower than those in healthy control group before dialysis（P〈0.01）,while,there was no significant difference regarding ET-1 and Vitamin B6 levels between these two groups（P〉0.05）.Before dialysis,serum H2 S level was positively correlated with NO,NO/ET-1,sulfhemoglobin and eGFR（P〈0.01）,while negatively correlated to serum creatinine.After dialysis,serum H2 S level increased significantly,while NO,NO/ET-1 decreased significantly.However,the levels of ET-1,sulfhemoglobin and Vitamin B6,compared with those before dialysis,did not change significantly after dialysis.Conclusions：Serum H2 S level in patients undergoing MHD decreases significantly and it is significantly correlated with NO,sulfhemoglobin and renal function.Compared with that before hemodialysis,the serum H2 S level increased significantly after hemodialysis.