腹膜透析患者腹透液中细胞因子水平的研究

Level of cytokines in peritoneal dialysate effluent of p eritoneal dialysis patients

目的 研究不卧床持续性腹膜透析 (CAPD)患者腹透液中转移生长因子 β1 (TGF β1 )水平及影响因素对腹膜小分子物质清除功能的影响。方法 测定CAPD患者血浆中和腹透液中TGF β1 、IL 6、TNF、CRP(C反应蛋白 )水平 ;同时统计CAPD患者腹透液葡萄糖含量、交换量、次数、留腹时间及腹膜炎次数 ;计算CAPD患者KpT V、Cpcr。结果 CAPD患者血浆中IL 6、TNF、CRP水平均明显高于正常健康人 ,P <0 .0 5～ 0 .0 1;透析第 12月 (KpT V +Cpcr) 2较第 3月下降超过 10 %的CAPD患者其腹透液中TGF β1、IL 6、TNF、CRP、葡萄糖浓度、腹膜炎次数均较对照组明显升高 ,P <0 .0 5～ 0 .0 1;腹透液中TGF β1 与IL 6、TNF、CRP、腹透液中葡萄糖浓度呈正相关 ,P <0 ..0 5～ 0 .0 1,与腹膜炎次数无关 ;腹透液中CRP与葡萄糖浓度、腹膜炎次数呈正相关 ,P <0 .0 5～ 0 .0 1,与腹膜交换量、次数、留腹时间无关。结论 CAPD患者体内确实存在慢性炎症状态 ,其炎症标志性因子CRP与腹透液葡萄糖浓度、腹膜炎次数有关 ,CAPD患者腹膜物质转运功能丧失与TGF β1 、IL 6、TNF、CRP升高有关。

Objective To investigate the effect of peritoneal dialysate efflu ent(PDE) level of TGF-β 1 and related factors on the peritoneal transport mec hanism. Methods We measured TGF-β 1,IL-6,TNF,CRP of plasma or PDE in CA PD patients,meanwhile added up the concentration of glucose,exchanged volume and t imes;abdomen retaining time of PDE,peritonitis times,KpT/V and Cpcr were calcula ted. Results The plasma levels of IL-6,TNF and CRP in CAPD patients wer e significantly higher than those of IL-6,TNF and CRP in normal controls (P< 0.05～0.01);As far as the CAPD patients whose (KpT/V+Cpcr)/2 in the twelfth mont h was 10% lower than those in the third month were concerned,the PDE level of T GF-β 1,IL-6,TNF,the concentration of glucose and peritonitis times were obvi ously higher than those of TGF-β 1,IL-6,TNF,CRP, the concentration of glu cose,and peritonitis times in controlled subjects (P<0.005～0.01). A positiv e cor relation was found between the PDE level of TGF-β 1 and those of IL-6,TNF,CR P and the concentration of glucose (P< 0.05 ～0.01).The PDE level of TGF- β 1 ha d no correlation with peritonitis times.The PDE level of CRP had a good correlat ion with the concentration of glucose and peritonitis times (P<0.05～0.01). I t had no correlation with exchanged volume,number of times and the interval in a bdominal cavity. Conclusion The chronic inflammatory status is in CAPD patients in deed.The inflammation-symbolized factor-CRP is related with the PDE concentra tion of glucose and peritonitis times. The de-function of peritoneal transport mechanism is concerned with the rise of TGF-β 1,IL-6,TNF and CRP.