本文關(guān)鍵詞：腹膜透析患者血清蛋白結(jié)合毒素水平及影響因素分析　出處：《第二軍醫(yī)大學(xué)學(xué)報(bào)》2017年10期 　論文類型：期刊論文

  更多相關(guān)文章： 蛋白結(jié)合毒素 硫酸吲哚酚 硫酸對甲酚 腹膜透析 影響因素

【摘要】：目的比較腹膜透析(PD)患者與健康人群血清蛋白結(jié)合毒素(PBT)代表物質(zhì)硫酸吲哚酚(IS)和硫酸對甲酚(PCS)水平的差異,并探討影響IS及PCS水平的因素。方法納入2015年2月至7月第二軍醫(yī)大學(xué)長征醫(yī)院腹透中心符合入選標(biāo)準(zhǔn)的72例PD患者及同期體檢中心的24例健康志愿者,采集空腹靜脈血3mL。采用高效液相色譜-電噴霧電離串聯(lián)質(zhì)譜法(HPLC-ESI-MS/MS)檢測血清中總IS、PCS以及游離IS、PCS濃度,采用簡單線性相關(guān)及多元線性回歸方法分析IS、PCS與年齡、性別、小分子毒素、腹透充分性、殘余腎功能、營養(yǎng)及C-反應(yīng)蛋白(CRP)等因素的相關(guān)性。結(jié)果 PD患者血清總IS及總PCS濃度高于健康志愿者(P0.001)。無殘腎功能PD患者血清總IS濃度高于有殘腎功能者(P=0.001)。血清總IS與血清游離IS(r=0.719,P0.01)、透析齡(r=0.306,P0.01)呈正相關(guān),與殘腎尿素清除指數(shù)(Kt/V;r=-0.372,P0.01)、殘腎肌酐清除率(Ccr;r=-0.515,P0.01)、殘腎腎小球?yàn)V過率估計(jì)值(eGFR;r=-0.495,P0.01)呈負(fù)相關(guān)。血清游離IS與殘腎Ccr(r=-0.430,P0.01)、殘腎eGFR(r=-0.431,P0.01)負(fù)相關(guān)。血清總IS和游離IS均與年齡、血紅蛋白、CRP無明顯相關(guān)性。結(jié)論 PD患者血清IS水平與患者殘腎功能呈負(fù)相關(guān),與年齡、性別和CRP無明顯相關(guān)性,提示保護(hù)殘腎功能有利于PD患者清除血清中的IS。
[Abstract]:Objective to compare the peritoneal dialysis (PD) patients and healthy human serum protein binding toxin (PBT) on behalf of the material indoxyl sulfate (IS) and p-cresol sulfate (PCS) level differences, and to explore the influencing factors of the IS and PCS level. Methods: 24 healthy volunteers were included in the dialysis center of Changzheng Hospital from February 2015 to July with 72 cases of Second Military Medical University PD patients and medical examination center of the selected standard, fasting venous blood 3mL. by high performance liquid chromatography electrospray ionization tandem mass spectrometry (HPLC-ESI-MS/MS) detection of serum total IS, PCS and free IS, the concentration of PCS, using simple linear correlation and multiple linear regression analysis of IS, PCS and age, gender, small molecule toxin, peritoneal dialysis adequacy and residual renal function, nutritional and C- reactive protein (CRP) correlation factors. Results the serum total IS and total PCS in patients with PD was significantly higher than that in healthy volunteers (P0.001). No residual renal function PD The concentration of serum total IS was higher than that of residual renal function (P=0.001). The total serum IS and serum IS (r=0.719, P0.01), dialysis age (r=0.306, P0.01) were positively correlated with residual renal urea clearance index (Kt/V; r=-0.372, P0.01), residual renal creatinine clearance rate (Ccr; r=-0.515, P0.01) the remnant kidney, estimated glomerular filtration rate (r=-0.495, eGFR; P0.01). Serum IS was negatively correlated with residual renal Ccr (r=-0.430, P0.01), eGFR (r=-0.431, residual kidney P0.01) negative correlation. Serum total IS and free IS were associated with age, hemoglobin CRP, there was no significant correlation between serum IS level. Patients with PD had negative correlation with residual renal function in patients with no significant correlation with age, gender and CRP, suggesting that protection of residual renal function in patients with PD is beneficial to the clearance of serum IS.

【作者單位】： 第二軍醫(yī)大學(xué)長征醫(yī)院腎內(nèi)科;
【基金】：國家自然科學(xué)基金(81570621)~~
【分類號】：R459.5
【正文快照】： [Acad J Sec Mil Med Univ,2017,38(10):1238-1243]腹膜透析(peritoneal dialysis,PD)是腎臟替代治療的重要方式之一,利用自身腹膜等半透膜的作用,緩慢持續(xù)清除體內(nèi)潴留的代謝產(chǎn)物和過多的水分,達(dá)到腎臟替代或支持治療的目的。越來越多的研究表明,蛋白結(jié)合毒素(protein-bound

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