背景:腹膜小溶质转运的相关因素尚未完全了解。本研究旨在探讨透析液炎症标志物(如巨噬细胞移动抑制因子,MIF)中腹膜透析(PD)流出物和腹膜溶质转运率(PSTR)的性质。
方法:本研究纳入邵阳第一医院80例稳定的PD患者。隔夜PD流出物和血清炎症标志物,包括MIF,MCP-1,VEGF,检测IL-6、TNFα和TGFβ。采用Pearson相关分析和Logistic回归分析确定PSTR升高的危险因素。
结果:MIF值增加的趋势,与具有低PSTR的受试者相比,在具有高PSTR的受试者中观察到PD流出物中的MCP-1和IL-6。Pearson相关检验表明,D/PCr与透析出水MIF呈正相关(r=0.32,p=0.01),MCP-1(r=0.47,p=0.01),IL-6(r=0.48,p=0.01)。相反,D/PCr与TGF-β无显著相关性(r=0.04,p=0.70),TNF-α(r=0.22,p=0.05),VEGF(r=0.02,p=0.86)和血清炎症标志物。在未调整的回归分析中,透析流出物MIF(OR2.41),MCP-1(或1.72),IL-6(OR1.55)与高PSTR状态相关。多因素logistic回归分析显示,所有受试者的透析流出物MIF对高PSTR的调整比值比(OR)为2.47(p=0.03)。
结论:MIF升高,PD流出物中的MCP-1和IL-6水平与增加的PSTR相关。透析流出物MIF水平升高是PD治疗受试者高PSTR的独立危险因素。
BACKGROUND: The associated factors of peritoneal small solute transport was not fully understood. This research aimed to investigate the connection between dialysate inflammatory markers (e.g. macrophage migration inhibitory factor,
MIF) in peritoneal dialysis (PD) effluent and peritoneal solute transport rate (PSTR) properties.
METHODS: A total of 80 stable PD patients in the First ShaoYang Hospital were enrolled in present
study. Overnight PD effluent and serum inflammatory markers including
MIF, MCP-1, VEGF, IL-6, TNFα and TGFβ were detected. Pearson correlation analysis and Logistic regression was performed to determine the risk factors for the increased PSTR.
RESULTS: A trend toward increased values of
MIF, MCP-1 and IL-6 in PD effluent was observed in subjects with high PSTR when compared with those with low PSTR. The Pearson correlation test showed that D/P Cr exhibited positive correlations with dialysis effluent
MIF (r=0.32, p=0.01), MCP-1 (r=0.47, p=0.01), IL-6 (r=0.48, p=0.01). Conversely, no significant correlation was found between D/P Cr and TGF-β (r=0.04, p=0.70), TNF-ɑ (r=0.22, p=0.05), VEGF (r=0.02, p=0.86) and serum inflammatory markers. In the unadjusted regression analysis, dialysis effluent MIF (OR 2.41), MCP-1 (OR 1.72), IL-6 (OR 1.55) were associated with high PSTR condition. Multivariate logistic regression analysis showed that the adjusted odds ratios (OR) of dialysis effluent MIF for high PSTR were 2.47 in all subjects (p=0.03).
CONCLUSIONS: Elevated MIF, MCP-1 and IL-6 levels in PD effluent were associated with increased PSTR. Elevated dialysis effluent MIF levels was an independent risk factor for high PSTR in subjects with PD treatment.