腹膜透析患者腹透液中HIF-1α与TGF-β1、IL-6、CRP及腹膜转运功能的相关性研究

摘要

目的:研究腹膜透析患者腹透液中低氧诱导因子1α(HIF-1α)的表达水平与TGF-β1、IL-6、CRP和腹膜转运功能的相关性,初步探讨HIF-1α对腹膜功能的影响以及可能的作用机制.方法:用ELISA法测定腹透患者腹透流出液中HIF-1α与TGF-β1、IL-6、CRP水平;并统计腹透患者的腹膜炎发生次数;行4 h腹膜平衡试验,计算腹透液肌酐和血肌酐比值(D/Pcr).结果:短期、中期和长期腹透组患者腹透液中HIF-1α的表达水平均明显高于初始腹透组(P均<0.05);长期腹透组HIF-1α的水平高于中期组(492.65±84.89 vs.288.92±78.93,P<0.05);中期腹透组HIF-1α的水平高于短期组(288.92±78.93 vs.241.05±72.41,P<0.05).HIF-1α高水平组的IL-6、CRP、TGF-β1和D/Pcr均高于HIF-1α低水平组(P均<0.05).相关性分析显示腹透液中HIF-1α的水平与IL-6、CRP、TGF-β1和D/Pcr正相关(r=0.512,P<0.001; r=0.506,P<0.001;r=0.722,P<0.001;r=0.354,P=0.001).腹透液中HIF-1α和TGF-β1的表达水平与腹膜炎次数无关(P>0.05).结论:腹透患者腹透液中HIF-1α的表达水平随着腹透龄的延长逐渐升高.HIF-1α可能通过影响腹膜慢性炎症状态和腹膜纤维化进展而影响腹膜功能.%Objective:To investigate the HIF - la level in peritoneal dialysate effluent ( PDE ), and its relationship with TGF - β1, IL -6, CRP and peritoneal funetion. To explore the effect of HIF - la on peritoneal function and its possible mechanism. Methods: We measured the levels of HIF - 1α, TGF - β1 , IL -6 and CRP in PDE in peritoneal dialysis patients. The length of peritoneal dialysis and peritonitis times in the last two years were recorded. Four hours peritoneum equilibrium test was enforced calculate D/Pcr. Results:HIF - 1α levels in short - term, middle - term and long - term peritoneal dialysis group were significantly higher than those in initial peritoneal dialysis group ( all P < 0. 05 ); HIF - 1α in long - term group was higher than that in middle - term group ( 492.65 ±84.89 vs. 288. 92 ± 78. 93, P < 0. 05 ); HIF - 1α in middle - term group was higher than that in short - term group ( 288.92 ±78.93 vs. 241.05 ±72.41, P<0.05 ). The levels of IL-6, CRP, TGF - β1 and D/Pcr in HIF-1α higher group were significantly higher than that in HIF - 1α lower group ( all P < 0. 05 ). A positive correlation was found between the level of HIF - 1α and IL-6, CRP, TGF - β1 , D/Pcr ( r = 0.512, P< 0.001; r = 0.506, P< 0.001; r= 0.722, P < 0.001; r= 0.354, P =0.001 ). The level of HIF - 1α and TGF - β1 had no correlation with peritonitis times ( P > 0. 05 ). Conclusion: The levels of HIF - 1 α in PDF of peritoneal dialysis patients increased significantly with the growth of peritoneal dialysis length. HIF -1α may affect the chronic inflammatory status and peritoneum fibrosis, and then deteriorate peritoneal function.