透出液中白介素6和血管生成素受体Tie-2水平与腹膜溶质高转运的关系

摘要

Objective To investigate the association of interleukin-6 (IL-6) and angiopoietin receptor Tie2 in dialysate with high peritoneal solute transport in patients undergoing peritoneal dialysis. Methods Sixty patients undergoing stable continuous ambulatory peritoneal dialysis (CAPD) were included, and were divided into two groups according to the values of dialysis/plasma creatinine ( D/Pcr) at 4 h in peritoneal equilibration test. D/Pcr was <0. 65 in L/A group ( n = 39), while that was≥0.65 in H/A group (n = 21). The mass concentrations of IL-6 and Tie-2 in dialysate of two groups were measured by ELISA, and the association of IL-6 and Tie-2 with D/Pcr was explored. Results The mass concentrations of IL-6 and Tie-2 in dialysate of H/A group were (21.71 ±8. 88) pg/mL and (1.23 ±0.43) ng/mL respectively, and were significantly higher than those of L/A group, which were (13.94 ±5.43) pg/mL and (0.95 ±0.43) ng/mL respectively (P<0.05). Univariate correlation analysis indicated that both IL-6 and Tie-2 in dialysate were positively related to D/Pcr (r = 0. 366, P = 0. 004; r = 0. 402, P = 0. 001), and multiple stepwise regression analysis revealed that IL-6 and Tie-2 in dialysate were independent risk factors for D/Pcr (β =0.007, P =0. 026; β =0.162, P =0. 006). Conclusion Significant abdominal inflammation and angiogenesis may exist in patients undergoing CAPD with high peritoneal solute transport status. IL-6 and Tie-2 in dialysate are independent risk factors for peritoneal permeability, which indicates abdominal inflammation and angiogenesis may be related to the change of peritoneal permeability.%目的 探讨腹膜透析(腹透)患者透出液中白介素6(IL-6)和血管生成素受体Tie-2水平与腹膜高通透性的关系.方法 将60例稳定的持续性非卧床性腹膜透析(CAPD)患者,根据腹膜平衡试验中4h透出液肌酐与血浆肌酐的比值(D/Pcr)分为L/A组(D/Pcr ＜0.65,n=39)和H/A组(D/Pcr≥0.65,n=21).采用ELISA法检测两组患者透出液中IL-6和Tie-2的质量浓度,分析IL-6和Tie-2水平与D/Pcr的相关性.结果 H/A组患者透出液中IL-6和Tie-2的质量浓度分别为(21.71±8.88)pg/mL和(1.23±0 43) ng/mL,均显著高于L/A组患者的(13.94±5.43) pg/mL和(0.95±0.43) ng/mL(P＜ 0.05).单因素相关分析结果显示:透出液中IL-6和Tie-2水平均与D/Pcr呈正相关(r=0.366,P =0.004;r =0.402,P =0.001)；多元逐步回归分析结果显示:透出液中IL-6和Tie-2水平是影响D/Pcr的独立危险因素(β=0.007,P=0.026；β=0.162,P=0.006).结论 腹膜高转运的CAPD患者存在较明显的腹腔局部炎症和血管新生.透出液中IL-6和Tie-2水平是影响腹膜通透性的独立危险因素,提示腹腔局部炎症和血管新生与腹膜通透性的改变有关.