中国血液净化

›› 2002, Vol. 1 ›› Issue (8): 14-17.

• 论著 • 上一篇    下一篇

尿毒症状态及透析膜对尿毒症患者产生肿瘤坏死因子α的影响

黄 雯 刘 锐 刘 平   

  1. 100034 北京，北京大学第一医院肾内科(现首都医科大学北京同仁医院肾内科 黄 雯) 刘 平 100034 北京，北京公安医院进修医师(刘 锐)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-08-19 发布日期:2002-08-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-08-19 Published:2002-08-19

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摘要： 【摘要】目的 观察尿毒症患者血浆肿瘤坏死因子α（TNFα）水平及铜仿膜（Cup）和血仿膜（Hp）透析器对尿毒症患者产生TNFα的影响。方法 采用体外细胞培养，酶联免疫(ELISA）和斑点杂交方法检测了25名尿毒症患者〔其中11人为未行血液透析者，14名为维持性血液透析患者（MHD）〕和15名正常人的TNFα水平及外周血单个核细胞（PBMC）培养上清（Lps 10mg/L，24h-1）中TNFα的水平和mRNA的表达。结果 未透析尿毒症患者血浆TNFα水平升高，但与正常对照相比，无显著性差异 （P>0.05），MHD 铜仿膜透析患者，血浆TNFα水平明显高于正常对照组，有显著性差异 （P<0.05）；尿毒症患者的PBMC培养上清中TNFα水平明显高于正常人（P<0.05），TNFαmRNA的表达在铜仿膜透析5分钟时明显升高，较正常对照和透析前有显著差异（1.61±0.17 vs 0.84±0.06 和1.61±0.17 vs 1.10±0.04，P均<0.05）。血仿膜组PBMC培养上清中TNFα水平及其mRNA的表达则呈下降趋势。结论 尿毒症患者血浆TNFα水平升高。铜仿膜透析可导致尿毒症患者TNFα合成和释放的增多。

关键词: 尿毒症, 维持性血液透析, 铜仿膜, 肿瘤坏死因子α

Abstract:

【Abstract】 Objective To observe plasma level of TNFα in uremia and the influence of Cuprophane (Cup) and Hemophane (Hp) on production of tumor necrosis fact or alpha (TNFα) in maintenance hemodialysis (MHD) patients. Methods by in vitro incubation of peripheral blood monoe uclear cell (PBMC, LPS 10mg/L, 24h), ELISA and dot blot hybrodization to detect plasma TNFα levels, production and gene expression of TNFα by PBMC in 11 non-dialysis uremia patients, 14 MHD ones and 15 normal individuals. Results compared with normal control group, plasma TNFα level in uremic patients was higher, but was without significance (P>0.05). In MHD group equipped with Cup membrane, plasma TNFα level was elevated evidently with significance (P<0.05); after in vitro incubation of PBMC (LPS 10mg/L, 24h), the protein and gene expression of TNFα were higher than normal control either in non-dialysis patients or in MHD ones (P<0.05); During a hemodialysis(HD) session, the maximal amount of TNFα mRNA was detected at five minutes after the beginning of HD in group equipped with Cup (1.61±0.17 vs 0.84±0.06, and 1.61±0.17 rs 1.10±0.04 P<0.05), Simultaneously companion the increasing of protein levels of TNFα with significance. Conclusion Uremia and Cuprophane dialyer can stimulate PBMC to product TNFα.

Key words: Maintenance hemodialysis, Cuprophane tumor necrosis factor alpha