【摘要】 目的 :研究不卧床持续性腹膜透析 (CAPD)患者血浆和腹膜透析排出液中细胞因子的水平与腹膜透析和机体防御功能的关系。方法 :用酶免疫法测定 2 1例非感染期 CAPD患者血浆和腹膜透析排出液中 IL - 1α、IL - 1β、IL - 6、TNFα、IFNγ和可溶性肿瘤坏死因子受体 1(s TNFR1)水平 ,同时做 4 h腹膜平衡试验。比较细胞因子水平与腹透情况和腹膜转运特性的关系 ;另外 ,与同期测定的正常人血浆 IL - 6和 s TNFR1水平作对比研究。结果 :2 1例 CAPD患者血浆和腹透液中各种细胞因子水平分别为 :IL - 1α 34.4 0 ng/ L± 12 .87ng/ L和 17.0 0 ng/ L± 10 .4 9ng/ L (P<0 .0 0 1) ;IL - 68.10 ng/ L± 14 .6 9ng/ L和 15 7.6 5 ng/ L± 130 .2 3ng/ L (P<0 .0 0 1)、TNFα117.30 ng/ L± 195 .2 7ng/ L和 2 2 .90 ng/ L±13.37ng/ L (P<0 .0 5 ) ;s TNEFR19.76μg/ L± 0 .98μg/ L和 1.84μg/ L± 2 .72μg/ L (P<0 .0 0 1)。仅在 8例患者血浆及9例患者腹透液中检测出 IL - 1β;在 1例患者血浆中测到 IFNγ,腹透液中 IFNγ为 2 .14 KU/ L± 0 .74 KU / L。腹透液中IL - 6和 IFNγ水平呈负相关 (P<0 .0 2 )。血浆和腹透液中各种细胞因子水平与腹透时间长短、既往感染与否、透析充分性和超滤量以及腹膜转运特性均?更多还原

【Abstract】 Objecitve:To investiges the changes of plasma and peritoneal dialysate effluent(PDE)cytokies and to explore the linkage between the cytokines and defense function in continuous ambulatory peritoneal diaysis(CAPD)patients.Methods:21 CAPD patients (non-infective stage)were included in this study.The 4-hour peritoneal equilibration test(PET)was perfomed and cytokines(IL-1α、IL-1β,IL-6,TNFα,IFNγ and sTNFRl )were assessed using specific enzyme immunoassays(ELA)in plasma and over-night dwell PDE.The levels of cytokines were compared with respeet to the state of peritoneal dialsis dnd the peritoneal membrane transport characteristics. Levels of IL-6 and sTNFRI in plasma were also compard in CAPD patiets and in healthy controls.Results:The average plasma and PDE levels of IL-1a(34.4 ng/L±12.87 ng/L;17.60 ng/L±10.49 ng/L),IL-6(8.10 ng/L±14.69 ng/L;157.65 ng/L±130.23 ng/L),TNFα(117.30 ng/L±195.27 ng/L;22.90 ng/L±13.37 ng/L)and sTNFRI(9.76 μg/L±0.98 μg/L;1.84 μg/L±2.72 μg/L) were determined and compared to that of controls.Plasma IL-1β,plasma IFNr and PDE IL-1βwere found undetectable in most of the patients.PDE level of IFNγ was 2.14 KU/L±0.74 KU/L. A negative correlation was found between PDE levels of IL-6 and INFr .No significant difference was found for each of the cytokines between patients dialyzed over and under 12 months,between patients with and without pervious peritoneal infection,beteen patients with a weekly KT/V<2.0 and a weekly KT/V>2.0,between patients with high or high average PET and patients with low or low average PET.Plasma levels of IL-6 And sTNFR1 in these CAPD patients were higher than that in normal contols.Conclusion:The secreted IL-6 and IFNγ in PDE might be involved in the defense mechanism of the peritoneum.The length of dialysis duration,the anamesis of peitoneal infection,dialysis adequacy,ultra-filtration volumes and the peritoneal transport characteristics exert on significant changes on the plasma and PDE levels of the cytokines.更多还原