慢性血液透析患者透析前后血浆同型半胱氨酸的变化

Alteration of homocysteine before and after hemodialysis in chronic hemodialysis patients

目的 :通过对慢性血液透析患者透析前后血浆同型半胱氨酸的检测 ,了解血液透析 (聚砜膜F7透析器 )对慢性血液透析病人血浆同型半胱氨酸水平的影响。方法 :1 1例慢性血液透析患者 ,分别于透析前后 1 0min采取血样 ,另选 30例正常志愿者为对照组 ,抽取清晨空腹静脉血 ,肝素抗凝 ,于 30min内低温离心 7min(70 0g) ,分离血浆 ,采用高效液相色谱仪检测血浆同型半胱氨酸水平。结果 :①慢性血液透析患者血浆同型半胱氨酸水平透前为 (2 9.5 3± 1 3.5 9) μmol/L及透后为 (2 1 .30± 1 0 .81 ) μmol/L ,均明显高于正常对照组 (1 3.5 4±4 .4 9) μmol/L(P <0 .0 1 ) ;②慢性血液透析患者同型半胱氨酸水平透析后较透析前明显降低 (P <0 .0 1 )。结论 :①慢性肾功能不全血液透析患者的血浆同型半胱氨酸平均水平高于正常人 ;②血液透析 (聚砜膜F7透析器 )可以降低慢性肾功能不全血液透析患者血浆同型半胱氨酸的水平 ,对同型半胱氨酸有清除作用 。

Objective To determine the plasma hemocysteine (Hcy) concentration in chronic hemodialysis patients and controls, and the relation between chronic hemodialysis and the plasma total Hcy level in chronic hemodialysis patients. Methods Using HPLC FLD method, the plasma total Hcy concentration was determined in 11 patients with chronic hemodialysis and 30 healthy volunteers. Results The plasma total Hcy level in chronic hemodialysis was significantly higher than that in the controls (13.54±4.49 μmol/L)( P <0.01). The plasma total Hcy level after the hemodialysis (21.30±10.81 μmol/L)was lower than before the hemodialysis (29.53±13.59 μmol/L)( P <0.01). Conclusion The plasma total Hcy level in chronic hemodialysis patients was higher than that in the controls. Hemodialysis can clean the plasma Hcy in chronic hemodialysis patients, but it can not decrease it to the normal level.