中性pH、低GDPs腹膜透析液对腹膜透析患者腹膜透析液CA125的影响

The Effect of peritoneal dialysis fluid with neutral pH and low GDPs on CA125 level in peritoneal dialysispatients

目的观察中性pH-低葡萄糖降解产物(glucose degradation products,GDPs)腹膜透析液对腹膜透析(peritoneal dialysis,PD)患者糖类抗原125(cancer antigen 125,CA125)的影响,以评估其效果。方法以持续非卧床PD患者为研究对象,初始使用标准钙腹膜透析液透析,后使用中性pH、低GDPs腹膜透析液持续透析6个月。将使用标准钙腹膜透析液时设为A组,使用中性pH、低GDPs腹膜透析液6个月后设为B组,观察患者透出液CA125及血清CA125浓度,超滤量及是否具有透析痛。结果共纳入44例PD患者,其中男性24例,女性20例。与A组相比,B组患者透出液CA125(t=2.266,P=0.029)、血清CA125(t=2.575,P=0.014)、腹膜透析超滤量(Z=5.052,P<0.001)较高,血红蛋白(t=2.208,P=0.033)、钙离子(t=2.843,P=0.007)、磷离子(t=2.094,P=0.042)较低。结论腹膜透析患者使用中性pH、低GDPs腹膜透析液可以增加患者透出液CA125水平,间接提示腹膜间皮细胞损伤减少。

Objective To evaluate the effect of neutral pH and low glucose degradation products(glucose degradation products,GDPs)on CA125 in peritoneal dialysis(peritoneal dialysis,PD)patients.Methods Continuous ambulatory peritoneal dialysis patients were enrolled.These patients were initially dialyzed with standard calcium peritoneal dialysis solution,followed by 6 months of dialysis with neutral pH and low GDPs peritoneal dialysis solution.Compare the concentrations of CA125 in the exudate and serum,ultrafiltration volume,and whether there is dialysis pain of these patients when using standard PD fluid(group A)and after using neutral pH and low GDPs PD fluid(group B).Results A total of 44 PD patients were included,including 24 males and 20 females.Compared with group A,group B had higher effluent CA125(t=2.266,P=0.029),serum CA125(t=2.575,P=0.014),peritoneal dialysis ultrafiltration(Z=5.052,P<0.001),and lower hemoglobin(t=2.208,P=0.033),calcium(t=2.843,P=0.007),and phosphorus(t=2.094,P=0.042).Conclusion The peritoneal dialysis fluid with neutral pH,low GDPs can increase the CA125 level in peritoneal dialysis patients,which indirectly indicates the reduced damage of peritoneal mesothelial cells.