本文選題：透析膜 + 血液透析　； 參考：《大連醫(yī)科大學》2017年碩士論文

【摘要】：目的:血液透析是尿毒癥患者的主要治療方式之一,透析膜是決定透析效果最重要的因素,對透析膜表面吸附的蛋白的研究,以便于理解透析膜表面發(fā)生的生化反應,并且為透析膜的改良提供基礎。方法:選我院連續(xù)兩次透析分別應用金寶低通Polyflux14L(PAES/PVP/PA)透析器及費森尤斯低通Fx8(PS/PVP)透析器患者2名作為材料差異組;連續(xù)兩次透析分別應用金寶高通Polyflux140H透析器及金寶低通Polyflux14L透析器患者2名作為通量差異組。用離子液體(C12Im-Cl,氯化-1-十二烷基-3-甲基咪唑)處理入選患者使用的透析器(N=8),以洗脫透析膜上吸附的蛋白,蛋白酶解并化學標記后混合;取患者透析前、后血液,分離血清標本并酶解血清蛋白,化學標記后混合。應用LC-MS/MS的方法對血清蛋白及透析膜洗脫蛋白進行分離和鑒定,對蛋白質的分子量(MW)、等電點(p I)等分子信息和蛋白質功能進行對比或分析。結果:1.不同透析膜對蛋白的吸附規(guī)律不同,在吸附蛋白量方面,材料差異組:與PAES/PVP/PA合成膜相比,PS/PVP合成膜上有45種表達量升高,253種降低;通量差異組:與高通量透析膜相比,低通量透析膜上有284種表達量升高,174種表達量降低。在吸附蛋白的p I及MW分布方面,PAES/PVP/PA與PS/PVP合成膜在吸附蛋白的p I及MW無統計學差異(P0.05);高通量透析膜對MW40k Da,p I7.5的蛋白吸附比例高(p I:46%vs.29%,c2=11.293,P=0.001,MW:71%vs.57%,c2=8.133,P=0.004),低通量透析膜對MW 40k Da~100k Da,p I5.5~7.5的蛋白吸附比例高(p I:41%vs.30%,c2=4.906,P=0.027,MW:33%vs.22%,c2=5.978,P=0.014)。2.透析膜表面差異蛋白不同。材料差異組,甘露糖結合凝集素絲氨酸蛋白酶1,半乳糖凝集素1,特異性表達于PAES/PVP/PS合成膜上;熱休克蛋白70特異性表達于PS/PVP合成膜上。通量差異組,β2微球蛋白特異性表達于高通量透析膜上。結論:不同透析膜吸附蛋白質的量、p I、MW不同;蛋白質功能分析提示膜表面差異蛋白與免疫功能、應激反應和炎癥反應相關。
[Abstract]:Objective: hemodialysis is one of the main treatment methods for uremic patients. Dialysis membrane is the most important factor to determine the effect of dialysis. The study of the protein adsorbed on the surface of dialysis membrane is helpful to understand the biochemical reaction on the surface of dialysis membrane. It also provides the basis for the improvement of dialysis membrane. Methods: two consecutive dialyzers were used in our hospital. Two dialyzers were used as the material difference group, one was the Jinbao low pass Polyflux14L PAES / PVP / PA dialyzer and the other was Fx8 / PVP / PVP dialyzer with Fishenyus low pass dialyzer. Two consecutive dialysis patients were treated with Jinbao Qualcomm Polyflux 140H dialyzer and Jinbao low pass Polyflux 14L dialyzer as flux difference group. C12Im-Cl and 1-dodecyl -3-methyl imidazole chloride were used to treat the dialyzer used by the selected patients to elucidate the protein adsorbed on the dialysis membrane, proteolysis and chemically labeled mixture. The blood was taken from the patients before and after dialysis. The serum samples were separated and the serum proteins were hydrolyzed by enzyme. Serum protein and dialysis membrane elution protein were isolated and identified by LC-MS / MS method. The molecular information and protein function of protein were compared and analyzed. The result is 1: 1. The adsorption of protein on different dialysis membranes was different. In terms of the amount of protein adsorbed, the material difference group: compared with PAES / PVP / PA synthetic membrane, there were 45 kinds of protein expression increased and 253 species decreased in Pae / PVP / PA synthetic membrane, and the flux difference group: compared with high flux dialysis membrane, there were 45 kinds of protein expression increased and 253 species decreased in Pas / PVP / PA synthetic membrane. On low flux dialysis membrane 284 kinds of expression increased and 174 kinds of expression decreased. There was no significant difference between pas / PVP / PA and PSP / PVP / PA / PS / PVP synthetic membrane in the protein I and MW of the adsorbed protein, and the ratio of protein adsorbed by high throughput dialysis membrane to MW40k Daapi / I7.5 was higher than that of the high throughput dialysis membrane. The ratio of protein adsorbed by high throughput dialysis membrane to MW40k Daqipi I7.5 was higher than that of the high throughput dialysis membrane C211.293P0.001MW71vs.57s. The low flux membrane was dialyzed on MW 40k Daw 100k Dap I5.57.5. The protein adsorption ratio is high (vs.30) 4.906 (P0.027MW: 33vs.22c2) 5.978U (5.978%) and 0.014% (2.23). The protein adsorption ratio is higher than that of vs.30%, and the ratio of protein adsorption is higher than that of vs.30%, and the ratio of protein adsorption is high. Dialysate membrane surface differential protein is different. Material difference group, mannose binding lectin serine protease 1, galactose agglutinin 1, specific expression in PAES- PVP / PS synthesis membrane, heat shock protein 70 specifically expressed on PS/ PVP synthetic membrane. In flux difference group, 尾 2 microglobulin was specifically expressed on high flux dialysis membrane. Conclusion: the amount of protein adsorbed by different dialysis membranes is different, and the analysis of protein function indicates that the differential protein on membrane surface is related to immune function, stress response and inflammatory reaction.
【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R692.5

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