中国血液净化

›› 2011, Vol. 10 ›› Issue (1): 33-36.doi: 10.3969/j.issn.1671-4091.2011..00

• 临床研究 • 上一篇    下一篇

不同透析模式对内皮素及内源性洋地黄样物质的影响

沈东波 张 杰 周雪珍 沈 理 李冰贤 孙爱丽 陈凤娇 谢广兰 黄鹏玉 郭军利 江红梅   

  1. 珠海市人民医院
  • 收稿日期:2010-10-26 修回日期:1900-01-01 出版日期:2011-01-12 发布日期:2011-01-12

Influence of different dialysis models on plasma endothelin and serum endogenous digitalis-like substance

SHEN Dong-bo, ZHANG Jie, ZHOU Xue-zhen, SHEN Li, LI Bing-xian, SUN Ai-li, CHEN Feng-jiao, XIE Guang-lan, HUANG Peng-yu, GUO Jun-li, JIANG Hong-mei   

  1. 1Center for Blood Purification and 2Department of Nuclear Medicine, Zhuhai People’s Hospital, Zhuhai 519000, China
  • Received:2010-10-26 Revised:1900-01-01 Online:2011-01-12 Published:2011-01-12

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摘要： 目的 探索不同透析模式对慢性肾衰竭患者血浆内皮素(endothelin,ET)和血清内源性洋地黄样物质(endogenous digitalis-like substance,EDLS)的影响。 方法 选择维持性血液透析(maintenance hemodialysis,MHD)患者75例，随机均分为3组，分别行低通量血液透析(low-flux hemodialysis,LFHD)、高通量血液透析(high-flux hemodialysis,HFHD)和血液透析滤过(hemodiafiltration,HDF)，采用放射免疫法检测治疗前后血液ET和EDLS水平并与20例健康对照组比较。 结果 慢性肾衰竭患者血浆ET和血清EDLS水平明显高于健康对照组(P＜0.01)。LFHD组患者治疗后，血浆ET水平由(74.58±11.09)pg/ml升高至(89.97±26.09)pg/ml，而血清EDLS由(246.59±25.73)pg/ml 降至(211.96±25.01)pg/ml，两者治疗前后比较差异均有统计学意义(均P＜0.01)。HFHD组患者治疗后，血浆ET水平由(75.27±17.58)pg/ml 升高至(80.70±23.83)pg/ml，但治疗前后比较差异无统计学意义(P＞0.05)；血清EDLS由(250.92±28.71)pg/ml降至(212.56±27.40)pg/ml，治疗前后比较差异有统计学意义(P＜0.01)。HDF组患者治疗后，血浆ET水平由(76.66±17.53)pg/ml 降至(68.69±17.48)pg/ml，血清EDLS由(251.17±23.13)pg/ml 降至(210.65±20.60)pg/ml，两者治疗前后比较差异均有统计学意义(均P＜0.05)。治疗后ET水平在LFHD组和HFHD组升高，而在HDF组下降，其变化程度较LFHD组差异有统计学意义(P＜0.05)；3组治疗后血清EDLS均有明显下降，但下降程度比较差异无统计学意义(P＞0.05)。 结论 3种透析模式均可有效降低血清EDLS，HDF可明显降低血浆ET。

关键词: 内皮素, 内源性洋地黄样物质, 血液透析, 血液透析滤过

Abstract: Objective To investigate the influence of different dialysis models on plasma endothelin (ET) and serum endogenous digitalis-like substance (EDLS) in patients with chronic renal failure. Methods We enrolled 75 maintenance hemodialysis (MHD) patients to assign them randomly and equally into 3 groups: LFHD group in which patients were treated with low-flux hemodialysis, HFHD group in which they were treated with high- flux hemodialysis, and HDF group in which they were treated with hemodiafiltration. We also collected 20 healthy participants as controls. Plasma ET and serum EDLS were measured by radioimmunoassay in MHD patients before and after hemodialysis and controls. Results Plasma ET and serum EDLS were significantly higher in MHD patients than in the healthy controls (P<0.01). In LFHD group after treatment, plasma ET increased from 74.58±11.09pg/ml to 89.97±26.09pg/ml (P<0.01) and serum EDLS decreased from 246.59±25.73pg/ml to 211.96±25.01pg/ml (P<0.01). In HFHD group after treatment, plasma ET increased from 75.27±17.58pg/ml to 80.70±23.83pg/ml but without statistically difference (P>0.05), while serum EDLS decreased from 250.92±28.71pg/ml to 212.56±27.40pg/ml (P<0.01). In HDF group after treatment, plasma ET decreased from 76.66±17.53pg/ml to 68.69±17.48pg/ml (P<0.05), and serum EDLS decreased from 251.17±23.13pg/ml to 210.65±20.60pg/ml (P<0.01). Plasma ET increased in LFHD and HFHD groups after treatment, but decreased in HDF group after treatment (P<0.05, as compared with that in LFHD group). Serum EDLS decreased in LHFD, HFHD and HDF groups, but without statistical differences among the three groups (P>0.05). Conclusions Serum EDLS decreased significantly in LHFD, HFHD and HDF groups. In addition, plasma ET decreased preferably in HDF group.

Key words: Hemodiafiltration, Endothelin, Endogenous digitalis-like substance

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