本文選題：腹膜透析 + 血管內(nèi)皮生長(zhǎng)因子　； 參考：《中國(guó)老年學(xué)雜志》2016年03期

【摘要】：目的探討腹膜透析患者腹腔血管內(nèi)皮生長(zhǎng)因子(VEGF)及腫瘤壞死因子(TNF)-α水平對(duì)腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能的影響。方法回顧性分析該院2009~2012年收治的154例穩(wěn)定持續(xù)非臥床腹膜透析(CAPD)患者臨床資料,計(jì)算肌酐溶質(zhì)轉(zhuǎn)運(yùn)面積系數(shù)(MTACc)評(píng)價(jià)其腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能,分析基線及12個(gè)月后的MTACc水平及變化程度(ΔTACcr),同時(shí)采用酶聯(lián)免疫吸附法檢測(cè)腹膜透析液中的VEGF及TNF-α水平并計(jì)算兩者呈現(xiàn)率(AR),分析總體、腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能穩(wěn)定組(ΔTACcr均數(shù))和升高組(ΔTACcr≥均數(shù))的VEGF AR和TNF-αAR水平,根據(jù)四分位數(shù)間距將VEGF AR(≤56.47、56.48~75.23、75.24~98.17、98.18 pg/min)和TNF-αAR(≤22.57、22.58~36.91、36.92~47.55、47.56 pg/min)分為4個(gè)亞組,比較各亞組的基線資料,采用單因素和多因素Cox回歸分析影響腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能的因素。結(jié)果全組12個(gè)月后的MTACc為(7.28±0.92)ml/min,高于基線MTACc水平(P0.05);ΔTACcr為(0.87±0.26)ml/min,其中85例0.87 ml/min(穩(wěn)定組)和69例≥0.87 ml/min(升高組),ΔTACcr水平與VEGF AR及TNF-αAR均呈正相關(guān)(r=0.421、0.554,P均0.05)。穩(wěn)定組與升高組的腹膜Kt/V、殘腎功能、尿量、VEGF AR及TNF-αAR的差異有統(tǒng)計(jì)學(xué)意義(P0.05);腹膜Kt/V隨VEGF AR、TNF-αAR水平升高而明顯增加,殘腎功能、尿量隨VEGF AR、TNF-αAR水平升高而明顯降低(P0.05),且VEGF AR隨TNF-αAR水平亦升高(P0.05);影響腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能的因素有腹膜Kt/V、殘腎功能、尿量、VEGF AR及TNF-αAR,且以VEGF AR≤80 pg/min為參照,80 pg/min腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能增強(qiáng)的風(fēng)險(xiǎn)為11.965倍(95CI:5.416~26.434),而以TNF-αAR≤30pg/min為參照,30 pg/min的風(fēng)險(xiǎn)為7.997倍(95CI:3.813~16.776)。結(jié)論腹腔局部炎癥反應(yīng)及血管新生情況可影響腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能,腹膜透析液中的VEGF及TNF-α水平是預(yù)測(cè)腹膜溶質(zhì)轉(zhuǎn)運(yùn)功能改變的風(fēng)險(xiǎn)因素。
[Abstract]:Objective to investigate the effects of vascular endothelial growth factor (VEGF) and tumor necrosis factor (TNF- 偽) on peritoneal solute transport in peritoneal dialysis patients. Methods the clinical data of 154 patients with stable continuous ambulatory peritoneal dialysis (CAPDD) admitted in our hospital from 2009 to 2012 were retrospectively analyzed and their peritoneal solute transport function was evaluated by calculating the creatinine solute transport area coefficient (MTACc). The levels and changes of MTACc in baseline and 12 months were analyzed. The levels of VEGF and TNF- 偽 in peritoneal dialysate were detected by enzyme-linked immunosorbent assay (Elisa). The levels of VEGF AR and TNF- 偽 AR in peritoneal solute transport function stable group (螖 TACcr mean) and elevated group (螖 TACcr 鈮，

本文編號(hào)：1896951