中国血液净化

中国血液净化 ›› 2020, Vol. 19 ›› Issue (11): 760-763.doi: 10.3969/j.issn.1671-4091.2020.11.010

• 基础研究 • 上一篇    下一篇

不同血液透析方式对大鼠体内硫酸吲哚酚清除影响的研究

刘书馨1,肖佳1,单婧1,李琳1,梅芳芳1,周佳楠1,姜欣1,李景煜2,韩璐璐2,贾凌云2   

  1. 1大连市中心医院肾内科
    2大连理工大学生命科学与技术学院
  • 收稿日期:2020-04-10 修回日期:2020-09-09 出版日期:2020-11-12 发布日期:2020-11-05
  • 通讯作者: 刘书馨 root8848@sina.com E-mail:root8848@sina.com
  • 基金资助:
    大连市科技创新基金项目(2019J13SN101)；大连市卫生健康委项目(1911018)

Study on the effect of different hemodialysis methods on the clearance of indoxyl sulfate in rats

  1.  1Department of Nephrology, Dalian Central Hospital, Dalian 116033;  2College of Life Science and Technology, Dalian University of Technology, Dalian 116024, China
  • Received:2020-04-10 Revised:2020-09-09 Online:2020-11-12 Published:2020-11-05
  • Contact: Xin ShuLiu E-mail:root8848@sina.com

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摘要： 【摘要】目的构建体内硫酸吲哚酚(indoxyl sulfate，IS)水平显著升高的肾功能不全大鼠模型，并完全模拟人类血液透析治疗模式对其进行治疗，观察不同血液透析方式对大鼠体内IS 清除的影响。方法选取450～550g 雄性SD 大鼠24 只通过双肾切除+IS 静脉注射方法建立IS 水平显著升高的肾功能不全大鼠模型。将大鼠随机平均分为对照组(6h)，普通血液透析(hemodialysis,HD)组(4h)、延时血液透析组(6h)和血液透析滤过(hemodiafiltration，HDF)组(4h)，每30min 留取1 次动脉血样，高效液相色谱法检测IS 浓度。结果①建模：模型建立后30min 至60min 间大鼠体内IS 水平明显下降[(57.79±16.12)μg/ml 比(49.26±10.80)μg/ml]，此后平稳维持至360min(46.48±8.00μg/ml)(F=4.858，P=0.178)。②随着血液净化时间的延长，每组大鼠透析60min,120min,180min,240min 的IS 浓度两两相比都具有显著差异(HD 组F=24.719，P＜0.001；HDF 组F=44.086，P＜0.001；HD6h 组F=52.481，P＜0.001)。③对HD、
HDF 开始透析后各自在60min,120min,180min,240min 的IS 浓度作变化曲线后行方差分析，发现HDF 组IS的浓度下降程度显著大于HD(F=7.567，P=0.020)。而HD 由240min 延长至360min，IS 浓度无明显改变(P=0.555, 95% CI -0.777～1.284)。结论本实验成功构建了体内IS 水平显著升高的肾功能不全大鼠模型，建立了与人类完全类似的大鼠HD、HDF 治疗模式，从动物模型和小动物血液净化平台的角度证实HDF 对IS 的清除率高于HD，HD 对IS 的清除能力在治疗近4 小时左右达到饱和，继续延长HD 治疗时间不能增加IS的清除。

关键词: 血液透析, 血液透析滤过, 硫酸吲哚酚

Abstract: 【Abstract】Objective To establish a model of rats with high indoxyl sulfate (IS) level and then to study the effect of different dialysis modalities on clearance of IS. Methods Rat model of high IS level was established in 24 male SD rats. They were then divided into control group (n=6), HD (hemodialysis) 4h group (n=6), HD 6h group (n=6) and HDF (hemodiafiltration) group (n= 6). Arterial blood sample was taken every 30 minutes during dialysis. Blood IS concentration was assayed by HPLC. SPSS 24.0 was used for statistical analyses; P<0.05 was considered to be significant. Results ①Establishment of the rat model: IS level decreased significantly [(57.79±16.12)μg/ml vs. (49.26±10.80)μg/ml] after model establishment for 30～60min, then maintained the level (46.48±8.00)μg/ml to 360 min (P=0.178, F=4.858). ②IS level decreased gradually with HD (F=24.719, P＜0.001 for HD group; F=44.086，P＜0.001 for HDF group; F=52.481, P＜0.001 for HD 6h group). The clearance of IS with HDF was significantly higher than that with HD (F=7.567, P=0.020). IS level did not change significantly when HD prolonged from 240 min to 360 min (P= 0.555, 95% CI: -0.777～1.284). Conclusion The rat model of renal insufficiency with significant increase of IS level and the rat model treated with HD or HDF were successfully established. The clearance rate of IS using HDF was significantly higher than that using HD. The clearance ability of HD reached saturation about 4 hours after the treatment, and the clearance ability could not be further increased beyond 4 hours.

Key words: Hemodialysis, Hemodiafiltration, Indoxyl sulfate

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