透析液中结缔组织生长因子、纤溶酶水平与腹膜透析患者腹膜溶质转运速率的关系

Relationship between connective tissue growth factor and plasminogen levels in dialyzate and peritoneal solute transport rate in peritoneal dialysis patients

目的 探讨透析液中结缔组织生长因子(CTGF)、纤溶酶原激活物抑制剂-1(PAI-1)水平与腹膜透析(PD患者腹膜溶质转运速率(PSTR)的关系。方法 选取2020年1月至2022年12月江苏省连云港市第二人民医院收治的152例PD患者,根据标准腹膜平衡试验分为快速转运组和非快速转运组。采用酶联免疫吸附试验检测透析液中CTGF、PAI-1水平。采用多因素logistic回归分析PD患者PSTR快速转运的影响因素,采用受试者操作特征曲线分析透析液中CTGF、PAI-1水平对PD患者PSTR快速转运的评估价值。结果 152例PD患者PSTR快速转运发生率为57.24%(87/152)。快速转运组透析液中CTGF、PAI-1水平高于非快速转运组(P<0.05)。快速转运组透析龄、夜间超滤量高于非快速转运组,白蛋白水平低于非快速转运组(P<0.05)。透析龄延长(OR=1.051,95%CI:1.023~1.081)和CTGF(OR=1.298,95%CI:1.165~1.446)、PAI-1(OR=1.408,95%CI:1.205~1.646)升高为PD患者PSTR快速转运的独立危险因素(P<0.05)。透析液中CTGF联合PAI-1预测PD患者PSTR快速转运的曲线下面积大于二者单独预测(P<0.05)。结论 透析液中CTGF、PAI-1水平升高与PD患者PSTR快速转运独立相关,二者联合对PD患者PSTR快速转运评估价值较高,可能成为PD患者PSTR快速转运的辅助评估指标。

Objective To investigate the correlation of the levels of connective tissue growth factor(CTGF)and plasminogen activator inhibitor-1(PAI-1)in dialyzate and peritoneal solute transport rate(PSTR)in patients with peritoneal dialysis(PD).Methods One hundred and fifty-two PD patients admitted to the Second People’s Hospital of Lianyungang in Jiangsu Province from January 2020 to December 2022 were selected and categorized into rapid transit group and non-rapid transit group according to the standard peritoneal balance test.The levels of CTGF and PAI-1 in dialyzate were measured by enzyme-linked immunosorbent assay.Multi-factor logistic regression was used to analyze the factors influencing the rapid transfer of PSTR in PD patients,and the value of the levels of CTGF and PAI-1 in dialyzate for assessing the rapid transfer of PSTR in PD patients was analyzed using receiver operating characteristic curves.Results The incidence of PSTR rapid transit in 152 PD patients was 57.24%(87/152).The levels of CTGF and PAI-1 in dialyzate were higher in the rapid transit group than those in the non-rapid transit group(P<0.05).The dialysis age and nighttime ultrafiltration volume of the rapid transit group were higher than those of the non-rapid transit group,while the level of albumin was lower than that of the non-rapid transit group(P<0.05).The prolonged dialysis age(OR=1.051,95%CI:1.023-1.081)and elevated CTGF(OR=1.298,95%CI:1.165-1.446),PAI-1(OR=1.408,95%CI:1.205-1.646)were the independent risk factors of rapid transport of PSTR in patients with PD(P<0.05).The area under the curve of CTGF combined with PAI-1 in dialyzate to predict the rapid transport of PSTR in PD patients was higher than that of either alone(P<0.05).Conclusion Elevated levels of CTGF and PAI-1 in dialyzate are independently associated with rapid transport of PSTR in PD patients,and CTGF combined with PAI-1 is of higher value in the assessment of rapid transport of PSTR in PD patients,and may become an auxiliary assessment index of PSTR rapid transport in PD patients.