血液透析对慢性肾功能衰竭患者血浆髓过氧化物酶水平的影响

目的 探讨慢性肾功能衰竭维持性血液透析患者透析前、后血浆髓过氧化物酶水平的变化,分析其可能的原因及意义.方法 收集40例维持性血液透析患者透析前、后血标本各4 ml,其中2 ml置于乙二胺四乙酸抗凝管,2 ml置于普通试管,低温离心后分别收集血浆和血清.采用酶联免疫吸附法分别检测血浆髓过氧化物酶及血清中性粒细胞弹性蛋白酶的水平并比较透析前、后的变化.结果 透析前、后血浆髓过氧化物酶水平分别为(161±33)μg/L和(426±188)μg/L,治疗前、后比较差异有统计学意义(P＜0.01);透析前、后血清中性粒细胞弹性蛋白酶水平分别为(191±33)μg/L和(193±34)μg/L,治疗前、后比较差异无统计学意义(P＞0.05).结论 在维持性血液透析患者中应用肝素作为抗凝剂透析后,血浆髓过氧化物酶水平的升高并非由中性粒细胞释放所致,很可能是由肝素刺激血管壁固化髓过氧化物酶释放所致.

Changes of plasma mhyeloperoxidase ievels in patients with maintainance bemodialysis before and after dialysis

Objective To investigate the level of plasma NPO in patients with maintainance hemodialysis before and after dialysis,analyzing the possible causes and significance.Methods Specimen was drew from 40 patients with maintainance hemodialysis,each patient 4 ml,2 ml was put in EDTA-anticoagulant test tube,the remaining 2 ml was put in test tube without any anticoagulant.After low-temperature centrifugation,plasma and serum were collected.Plasma MPO and secrum NE levels before and after heparin administration were assessed by ELISA in 40 patients,comparing the changes before and after aialysis.Results A major increase[from(161±33)μg/L]to[(426±188)μg/L]was found in plasma MPO levels of before and after dialysis,statistically significant(P＜0.01);Whereas marked changes were not observed during secrum levels of NE from[(191±33)μg/L]to[(193±34)μg/L]before and after aislysis,was no significant difference(P＞0.05).Conclusions Our research demonstrated that,in the maintenance hemodialysis patients,the application of heparin,the elevation of MPO level after dialysis was not caused by the degranulation of polymorphonuclear cells,but may be determined by the release of blood veasel-bound MPO which stimulated by heparin.