摘要
目的比较不同透析方式对尿毒症患者体内非对称性二甲基精氨酸(asymmetic dimethylarginine,ADMA)的清除作用。方法选择我院血液净化中心行维持性血液透析(HD)、血液透析滤过(HDF)、连续性非卧床腹膜透析(CAPD)的终末期肾脏疾病患者60例,年龄18～60岁,检测其清晨空腹透析前血清ADMA的水平,测算每周透析清除ADMA的总量,对比HD组(20例)、HDF组(20例)、CAPD组(20例)患者与健康对照者(20例)的血清ADMA水平,比较维持性血液透析患者残余肾脏及透析每周清除ADMA的总量。结果透析的各组患者血清AD-MA水平与健康对照者比较差异均有统计学意义(P<0.01),CAPD组患者血清ADMA水平与HD组、HDF组比较差异有统计学意义(P<0.01),HD组与HDF组患者血清ADMA水平间差异无统计学意义(P>0.05);健康对照组每周尿量及ADMA经尿液的排泄量与透析的各组比较差异均有统计学意义(P<0.01),CAPD组尿量及ADMA排泄量与HD组、HDF组比较差异均有统计学意义(P<0.01),HD组与HDF组比较差异无统计学意义(P>0.05);HD组、HDF组、CAPD组每周透析清除ADMA的量间差异有统计学意义(P<0.05)。结论维持性血液透析患者的血清ADMA水平明显高于健康人,CAPD清除ADMA的能力优于HD和HDF,HDF清除ADMA的能力优于HD。
Objective To compare the removal effects of asymmetric dimethylarginine （ADMA） by different dialysis methods： Methods Sixty advanced nephropathic patients, who received in the blood purification center of our hospital maintenance hemodialysis （liD） （N = 20 ）, or hemodiafiltration （HDF） （N = 20 ） or continuous ambulatory peritoneal dialysis （CAPD） （N =20）, were enrolled, with 20 healthy persons as the controls. All the subjects aged from 18 To 60. The level of ADMA previous to the fasting dialysis in the morning was detected, and the total amount of ADMA was calculated. The serum ADMA levels in the three trial groups were compared with the control group in totally weekly removal amount of ADMA through urine and dialysis. Results The serum levels of ADMA in the three dialysis groups showed a significant differences from that in the control group （ P 〈 0. 01 ）. The serum concentration of ADMA in the CAPD patients was lower than those in the HD and HDF patients （ P 〈0.01 ）, but there was no significant difference in serum ADMA level between the HD and HDF patients （ P 〉 0. 05 ）. The weekly urine amount and the weekly removal amount of ADMA through urine in the three diaiysis groups showed a significant differences from that in the control group （ P 〈 0. 01 ）. The weekly urine amount and the weekly removal amount of ADMA through urine in the CAPD group showed a significant differences from those in the HD and HDF groups （ P 〈0.01 ） , but there was no significant difference between the HD and HDF groups （ P 〉 0. 05 ）. There were significant differences in weekly removal amount of ADMA by dialysis among HDF, HD and CAPD groups （ P 〈 0.05 ）. Conclusion The serum ADMA level of maintenance dialysis patients is markedly higher than that of healthy subjects. The removal efficacy of ADMA by CAPD is better than those by HD and HDF, and that by HDF is better than that by HD.
出处
《中国全科医学》
CAS
CSCD
2008年第21期1924-1927,共4页
Chinese General Practice
基金
北京市科技委员会基金资助项目(Y0204003041191)
