维持性腹膜透析患者腹膜转运特性对患者内皮功能炎症因子及氧化应激状态的影响
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摘要
目的:探讨维持性腹膜透析(MPD)患者腹膜转运特性对患者内皮功能、炎症因子及氧化应激状态的影响。方法:根据基础透析液/血浆肌酐比值(D/P),将我院肾内科收治的128例MPD患者分为高转运(HT,72例)组和低转运(LT,56例)组,另将我院同期性别、年龄相匹配的60例健康体检者纳入对照组,比较三组血流介导的扩张(FMD)及血清C反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超氧化物歧化酶(SOD)、丙二醛(MDA)、晚期氧化蛋白产物(AOPPs)水平,并分析腹膜转运特性与各因子的相关性。结果:HT组、LT组收缩压、血肌酐、甘油三酯、尿酸、营养不良发生率明显高于对照组(P<0.05),白蛋白明显低于对照组(P<0.05);LT组血肌酐、白蛋白、甘油三酯明显高于HT组(P<0.05);HT组、LT组FMD明显低于对照组(P<0.05),HT组FMD明显低于LT组(P<0.05);HT组、LT组血清CRP、IL-6、TNF-α水平明显高于对照组(P<0.05),HT组血清CRP、IL-6、TNF-α水平明显高于LT组(P<0.05);HT组、LT组血清SOD水平明显低于对照组(P<0.05),血清MDA、AOPPs水平明显明显高于对照组(P<0.05);HT组血清SOD水平低于LT组(P<0.05),血清MDA、AOPPs水平高于LT组(P<0.05);腹膜转运特性与FMD、SOD呈负相关(P<0.05),与CRP、IL-6、TNF-α、MDA、AOPPs呈正相关(P<0.05)。结论:MPD患者体内存在明显血管内皮功能紊乱及氧化应激、炎症反应,高腹膜转运特性者血管内皮功能紊乱程度和氧化应激、炎症反应水平高于低腹膜转运特性者。
Objective: To investigate the effects of peritoneal transport characteristics on endothelial function, inflammatory factors and oxidative stress in patients with maintenance peritoneal dialysis(MPD). Methods: According to the basic dialysate/plasma creatinine ratio(D/P), 128 MPD patients were divided into two groups: high transport(HT, 72 cases) and low transport(LT, 56 cases). Another 60 healthy persons matched in sex and age were included in the control group. The correlation between peritoneal transport characteristics and various factors was analyzed. Results:The systolic blood pressure, serum creatinine, triglyceride, uric acid and incidence rate of malnutrition in HT group and LT group were significantly higher than those in control group(P<0.05) while the albumin was significantly lower than that in control group(P<0.05). The serum creatinine, albumin and triglyceride in LT group were significantly higher than those in HT group(P<0.05). The FMD in HT group and LT group was significantly lower than that in control group(P<0.05), and the FMD in HT group was significantly lower than that in LT group(P<0.05). The levels of serum CRP, IL-6 and TNF-α in HT group and LT group were significantly higher than those in control group(P<0.05), and the levels of serum CRP, IL-6 and TNF-α in HT group were significantly higher than those in LT group(P<0.05). Serum SOD level in HT group and LT group was significantly lower than that in control group(P<0.05) while the levels of serum MDA and AOPPs were significantly higher than those in control group(P<0.05). Serum SOD level in HT group was lower than that in LT group(P<0.05) while the levels of serum MDA and AOPPs were higher than those in LT group(P<0.05). Peritoneal transport characteristics were negatively correlated with FMD and SOD(P<0.05), and were positively correlated with CRP, IL-6, TNF-α, MDA and AOPPs(P<0.05). Conclusions:There are obvious vascular endothelial dysfunction, oxidative stress and inflammatory reactions in patients with MPD. The degrees of vascular endothelial dysfunction and oxidative stress and inflammatory response are higher in patients with high peritoneal transport characteristics than those in patients with low peritoneal transport characteristics.
Objective: To investigate the effects of peritoneal transport characteristics on endothelial function, inflammatory factors and oxidative stress in patients with maintenance peritoneal dialysis(MPD). Methods: According to the basic dialysate/plasma creatinine ratio(D/P), 128 MPD patients were divided into two groups: high transport(HT, 72 cases) and low transport(LT, 56 cases). Another 60 healthy persons matched in sex and age were included in the control group. The correlation between peritoneal transport characteristics and various factors was analyzed. Results:The systolic blood pressure, serum creatinine, triglyceride, uric acid and incidence rate of malnutrition in HT group and LT group were significantly higher than those in control group(P<0.05) while the albumin was significantly lower than that in control group(P<0.05). The serum creatinine, albumin and triglyceride in LT group were significantly higher than those in HT group(P<0.05). The FMD in HT group and LT group was significantly lower than that in control group(P<0.05), and the FMD in HT group was significantly lower than that in LT group(P<0.05). The levels of serum CRP, IL-6 and TNF-α in HT group and LT group were significantly higher than those in control group(P<0.05), and the levels of serum CRP, IL-6 and TNF-α in HT group were significantly higher than those in LT group(P<0.05). Serum SOD level in HT group and LT group was significantly lower than that in control group(P<0.05) while the levels of serum MDA and AOPPs were significantly higher than those in control group(P<0.05). Serum SOD level in HT group was lower than that in LT group(P<0.05) while the levels of serum MDA and AOPPs were higher than those in LT group(P<0.05). Peritoneal transport characteristics were negatively correlated with FMD and SOD(P<0.05), and were positively correlated with CRP, IL-6, TNF-α, MDA and AOPPs(P<0.05). Conclusions:There are obvious vascular endothelial dysfunction, oxidative stress and inflammatory reactions in patients with MPD. The degrees of vascular endothelial dysfunction and oxidative stress and inflammatory response are higher in patients with high peritoneal transport characteristics than those in patients with low peritoneal transport characteristics.
引文
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