腹膜透析患者血清基质金属蛋白酶水平变化的意义

目的 了解维持性腹膜透析(CAPD)患者血清基质金属蛋白酶-10(MMP-10)、基质金属蛋白酶-8(MMP-8)、基质金属蛋白酶组织抑制剂-1(TIMP-1)的水平及可能临床意义。方法 选取住院CAPD及临床符合诊断慢性肾脏病(CKD)患者135例,分为CKD3、CKD4、CKD5期组和CAPD组,其中CAPD组68例;记录患者年龄、腹透龄等临床资料,收集并记录患者的血红蛋白(HB)、血清清蛋白(ALB)、血钙、血磷、甲状旁腺激素(PTH)、血肌酐等指标;血清MMP-10、MMP-8、TIMP-1检测采用酶联免疫吸附试验。结果 CAPD患者血清MMP-10、MMP-8、TIMP-1、血磷、钙磷乘积水平明显高于CKD3、4、5期患者,CAPD组血钙水平较CKD5期组高,差异有统计学意义(P<0.05);Spearman直线相关分析结果提示MMP-10与血磷、钙磷乘积呈正相关,与ALB呈负相关,MMP-8与血磷、hs-CRP、血沉、钙磷乘积呈正相关,TIMP-1与血磷呈正相关;上述3项指标均与血钙、年龄、PTH、腹透龄、血肌酐、HB不具有相关性。CAPD组中的高磷组MMP-10、MMP-8、TIMP-1水平较正常血磷组升高,钙磷乘积增高组较钙磷乘积正常组MMP-10、MMP-8、TIMP-1浓度高,但组间比较仅MMP-10水平差异有统计学意义。结论 CAPD患者血清 MMP-10、MMP-8、TIMP-1、血磷、钙磷乘积水平较透析前CKD患者明显升高;CAPD患者血清MMP-10、MMP-8、TIMP-1水平可能与钙磷代谢有关。

Serum levels of matrix metalloproteinases and clinical significance in peritoneal dialysis patients

Objective To investigate the serum levels of matrix metalloproteinases-10 (MMP-10),matrix metalloproteinases-8 (MMP-8),tissue inhibitor of metalloproteinase-1 (TIMP-1),and clinical significance in continuous ambulatory peritoneal dialysis(CAPD) patients.Methods 135 patients,who were diagnosed with CAPD or chronic kidney disease (CKD) from the hospitalized patients were enrolled in the study.They were divided into four groups: CAPD group (68 patients),CKD3 stage group,CKD4 stage group and CKD5 stage group.Collected the clinical data such as age,dialysis ages, hemoglobin (HB),serum albumin (ALB),Serum calcium,serum phosphate,parathyroid hormone,serum creatinine.ELISA was used for measurement of serum levels of MMP-10,MMP-8 and TIMP-1.Results Compared with the CKD groups,the serum MMP-10,MMP-8, TIMP-1and phosphate concentration, as well as the calcium-phosphorus product (Ca×P) were obviously increased in CAPD patients; serum calcium in CAPD patients was higher than CKD5 group,comparison between the two groups was statistically significant;Spearman correlation analysis in the CAPD group showed that serum MMP-10 concentration was positively correlated with serum phosphate,Ca×P,and negatively correlated with ALB;serum MMP-8 concentration was positively correlated with serum phosphate,hs-CRP,erythrocyte sedimentation rate,Ca×P; serum TIMP-1 concentration was positively correlated with serum phosphate; These three indicators were not statistically significant with serum calcium,age,PTH,dialysis ages, serum creatinine and HB.Classified into groups according to serum phosphate concentration and calcium-phosphorus(Ca×P) product in CAPD group,compared with the normal serum phosphate group,the serum MMP-10,MMP-8,TIMP-1 concentration were higher in the increased serum phosphate group.In the increased Ca×P group, these three indicators were higher than normal Ca×P group.But only differences between MMP-10 concentration was statistically significant.Conclusion Compared with the CKD groups,serum MMP-10,MMP-8,TIMP-1concentration,serum phosphate concentration and the calcium-phosphorus product (Ca×P) were increased in CAPD patients; The serum MMP-10,MMP-8 and TIMP-1 concentration of CAPD patients may associated with calcium and phosphorus metabolism.