摘要
目的探讨腹膜透析（腹透）患者腹腔白细胞介素6（IL-6）水平对腹膜溶质转运功能的影响。方法人选稳定持续非卧床腹膜透析（CAPD）患者128例，采用ELISA法测定腹透透出液IL-6的浓度，计算IL-6呈现率（appearancerate，AR），前瞻性观察患者肌酐溶质转运面积系数（masstransferareacoefficientofcreatinine，MTACcr）的变化。采用Logistic回归分析透出液IL-6AR对患者腹膜溶质转运功能改变的影响。结果人选患者的基线MTACcr中位数Ⅲ（1，4，3，4）]水平为6．40（4．70，8．75）ml／min，12个月后MTACcr[7．14（5．59，8．73）ml／min]较基线期明显升高（P〈0．05）。与腹膜溶质转运功能稳定组相比，溶质转运功能增高组患者腹透透出液IL-6AR明显升高277．08（247．45，349．53）pg／min比263．18（69．94，286．72）pg／min，P〈0．05]，残肾功能较低[0．79（0，2．12）mFmin比1．70（0．39，3．38）ml／min，P〈0．05]，尿量减少[225（0，600）ml／24h比500（125，900）ml／24h，P〈0．05]，患者基线MTACcr较低[5148（4．17，7．42）ml／min比7．00（5．46，9．76）mYmin，P〈0．05]。Logistic回归分析结果显示高透出液IL-6AR和低基线MTACcr是影响腹膜溶质转运功能远期改变的独立危险因素（均P〈0．05）。结论腹腔局部炎性反应影响腹膜溶质转运功能的改变，腹腔IL．6水平是预测腹膜溶质转运功能改变的独立危险因素。
Objective To evaluate the effect of dialysate interleukin-6 （IL-6）, a marker of ongoing peritoneal inflammation, on the alteration of peritoneal solute transport rates （PSTRs） in stable continuous ambulatory peritoneal dialysis （CAPD） patients. Methods A total of 128 case of stable CAPD patients were enrolled in present study. IL-6 levels in the overnight effluent were determined by ELISA and IL-6 appearance rates （AR） were calculated. Mass transfer area coefficients of creatinine （MTACcr） were prospectively followed up. Logistic regression was used to examine the association between IL-6 AR and increased PSTRs. Results The MTACcr was significantly increased after 12 months follow- up [M（1/4, 3/4）, 6.40（4.70, 8.75） ml/min vs 7.14（5.59, 8.73） ml/min, P〈 0.05]. Compared to the patients with stable PSTRs, the dialysate IL-6 AR in patients with increased PSTRs showed significantly higher [277.08（247.45, 349.53） pg/min vs 263.18 （69.94, 286.72） pg/min, P 〈 0.05]. Patients with increased PSTRs also had lower residual renal function [0.79（0, 2.12） ml/min vs 1.70 （0.39, 3.38） ml/min, P 〈 0.05], less urine volume [225（0, 600） ml/24 h vs 500（125, 900） ml/24 h, P 〈 0.05] and lower baseline MTACcr [5.48 （4.17, 7.42） ml/min vs 7.00（5.46, 9.76） ml/min, P 〈 0.05] when compared to their counterparts with stable PSTRs. Logistic analysis showed that high dialysate IL- 6 AR and low baseline MTACer were independent risk factors for increasing peritoneal solute transport rate （P 〈 0.05）. Conclusion Intra- peritoneal inflammation significantly affects the alteration of PSTRs, and the dialysate IL-6 may be a predictor for increased PSTRs in PD patients.
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
2013年第9期645-649,共5页
Chinese Journal of Nephrology
基金
上海市科委资助项目（07QA14040,08dz1900500,114119a5900）
关键词
炎症
白细胞介素6
腹膜透析
Inflammation
Interleukin-6
Peritoneal dialysis
