中国血液净化

›› 2011, Vol. 10 ›› Issue (7): 365-367.doi: 10.3969/j.issn.1671-4091.2011.07.00

• 临床研究 • 上一篇    下一篇

血液透析对终末期肾脏病患者炎症指标脂蛋白相关磷脂酶A2的影响

刘 阳 金绿英 李 莉 杜京涛   

  1. 宜昌市中心人民医院 三峡大学第一临床医学院肾内科
  • 收稿日期:2010-11-29 修回日期:1900-01-01 出版日期:2011-07-12 发布日期:2011-07-12

The influence of maintenance hemodialysis on the expression of inflammatory marker lipoprotein-associated phospholipase A2 in end stage renal disease patients

LIU Yang, JIN Lv-ying, LI Li, DU Jing-tao   

  1. 1Department of Nephrology, Yichang Central People’s Hospital, the First College of Clinical Medical Science, China Three Gorges University, Yichang 443003, China; 2Research Institute of Cardiovascular Disease, Renhe Hospital, China Three Gorges University, Yichang 443001, China
  • Received:2010-11-29 Revised:1900-01-01 Online:2011-07-12 Published:2011-07-12

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摘要：

目的 通过观察终末期肾脏病(end-stage renal disease,ESRD)患者血液透析前、后脂蛋白相关磷脂酶A2(lipoprotein-associated phospholipase A2,LpPLA2)的活性变化及血清C反应蛋白(C-reactive protein,CRP)的浓度水平，探讨血液透析对ESRD患者此炎症指标表达的影响。 方法 收集20例ESRD进行血液透析患者透析前、透析中2 h及透析完毕后外周血8 ml，年龄、性别相匹配的健康体检者20例作为正常对照组。利用免疫比浊法检测血清中CRP的浓度水平；酶联免疫吸附法测定LpPLA2的活性变化。 结果 在透析前，ESRD患者血清CRP的浓度水平均较正常对照组高(P＜0.01)；而LpPLA2的活性在ESRD患者和正常对照组之间差异无统计学意义(P＞0.05)。透析完毕后，血清CRP浓度水平与透析前、透析中差异均无统计学意义(均P＞0.05)；而LpPLA2的活性在透析中及透析完毕后均较透析前明显提高(P＜0.01)。 结论 血液透析对ESRD患者会产生微炎症状态，此炎症反应状态或许部分是通过提高LpPLA2的活性来介导的。

关键词: 脂蛋白相关磷脂酶A, 炎症, 血液透析

Abstract:

Objective To explore the influence of hemodialysis (HD) on the expression of inflammation marker lipoprotein-associated phospholipase A2 (LpPLA2) in end stage renal disease (ESRD) patients, we evaluated their changes in LpPLA2 activity and C-reactive protein (CRP) concentration before and after HD. Methods We observed 20 ESRD patients on HD, from whom 8ml peripheral blood were taken just before HD, after 2 h during HD, and immediately after HD. C-reactive protein was estimated by turbidometric assay, and LpPLA2 activity was measured by enzyme-linked immunosorbent assay (ELSA). Result In ESRD patients before HD, CRP concentration was higher than normal controls (P＜0.01), but LpPLA2 activity was indifferent from the controls (P＞0.05). In ESRD patients after a HD session, CRP concentration did not change significantly (P＞0.05), as compared to that before HD and after 2h during HD. However, LpPLA2 activity increased greatly after 2h during HD and after a HD session (P＜0.01), as compared to that before HD. Conclusion Hemodialysis can induce microinflammation in ESRD patients. This pro-inflammatory state may be introduced partially by the increase of LpPLA2 activity.

Key words: inflammation, lipoprotein-associated phospholipase A2