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维持性血液透析患者的血清硫化氢水平及其影响因素的分析
引用本文:陈月梅,贾平,邹建洲,刘中华,沈波,吕文律,陈利明,丁小强. 维持性血液透析患者的血清硫化氢水平及其影响因素的分析[J]. 中国临床医学, 2016, 23(1): 86-89
作者姓名:陈月梅  贾平  邹建洲  刘中华  沈波  吕文律  陈利明  丁小强
作者单位:复旦大学附属中山医院肾内科,上海 200032;浙江大学医学院附属第二医院肾内科, 杭州 310009,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032,复旦大学附属中山医院肾内科,上海 200032;上海市肾病与透析研究所,上海 200032;上海市肾脏疾病与血液净化重点实验室,上海 200032
基金项目:国家自然科学基金青年基金项目(编号:81300634);上海市卫生和计划生育委员会科研计划课题资助项目(编号:20114275) 陈月梅和贾平对本文有同等贡献,为共同第一作者。
摘    要:
目的:研究维持性血液透析患者的血清硫化氢水平及其影响因素。方法:根据筛选及排除标准,纳入符合要求的维持性血液透析患者150例,同时收集健康志愿者17名作为健康对照。留取患者透析前后血标本,健康对照组则清晨空腹抽血。检测血清硫化氢、一氧化氮、一氧化氮/内皮素-1及硫化血红蛋白等水平,并作相关性分析。结果 :维持性血液透析患者透析前血清硫化氢、一氧化氮/内皮素-1比值、硫化血红蛋白水平明显低于健康对照组(P0.01),而内皮素-1和维生素B6含量与健康对照组差异无统计学意义(P0.05);透析前血清硫化氢与一氧化氮、一氧化氮/内皮素-1比值、硫化血红蛋白及肾小球滤过率正相关(P0.01),而与血肌酐水平负相关;透析后血清硫化氢水平较透析前明显上升,一氧化氮水平和一氧化氮/内皮素-1比值明显下降,而内皮素-1、硫化血红蛋白及维生素B6水平在透析前后无明显变化。结论:维持性血液透析患者血清硫化氢水平明显降低,其水平与一氧化氮、硫化血红蛋白、肾功能等显著相关;血液透析后患者血清硫化氢水平较透析前显著升高。

关 键 词:硫化氢   血液透析   一氧化氮

Serum Level of Hydrogen Sulfide and Its Influential Factors in Patients Undergoing Maintenance Hemodialysis
Affiliation:Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Department of Nephrology, The Sencond Affliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China,Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China and Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China;Kidney Disease and Dialysis Institute of Shanghai, Shanghai 200032, China;Kidney Disease and Blood Purification Laboratory of Shanghai, Shanghai 200032, China
Abstract:
Objective: To investigate the serum level of hydrogen sulfide (H2S) and its influential factors in patients undergoing maintenance hemodialysis (MHD). Methods:Based on screening and exclusion criteria, 150 patients undergoing MHD were enrolled. Meanwhile, 17 healthy volunteers were collected as healthy controls. Venous blood samples of MHD patients were obtained before and after dialysis, and fasting blood samples were collected from healthy controls. The levels including serum H2S, nitric oxide (NO), endothelin-1 (ET-1), and sulfhemoglobin were detected and the correlations among them were analyzed. Results:The levels of serum H2S, NO, NO/ET-1 and sulfhemoglobin in patients undergoing MHD were significantly lower than those in healthy control group before dialysis (P<0.01), while, there was no significant difference regarding ET-1 and Vitamin B6 levels between these two groups (P>0.05). Before dialysis, serum H2S level was positively correlated with NO, NO/ET-1, sulfhemoglobin and eGFR (P<0.01), while negatively correlated to serum creatinine. After dialysis, serum H2S level increased significantly, while NO, NO/ET-1 decreased significantly. However, the levels of ET-1, sulfhemoglobin and Vitamin B6, compared with those before dialysis, did not change significantly after dialysis. Conclusions:Serum H2S level in patients undergoing MHD decreases significantly and it is significantly correlated with NO, sulfhemoglobin and renal function. Compared with that before hemodialysis, the serum H2S level increased significantly after hemodialysis.
Keywords:Hydrogen sulfide   Hemodialysis   Nitric oxide
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