CAJ | 학술논문

目的探讨腹膜透析(腹透)患者腹腔白细胞介素6(IL-6)水平对腹膜溶质转运功能的影响.方法入选稳定持续非卧床腹膜透析(CAPD)患者128例,采用ELISA法测定腹透透出液IL-6的浓度,计算IL-6呈现率(appearance rate,AR),前瞻性观察患者肌酐溶质转运面积系数(mass transfer area coefficient of creatinine,MTACcr)的变化.采用Logistic回归分析透出液IL-6 AR对患者腹膜溶质转运功能改变的影响.结果入选患者的基线MTACcr中位数[M(1/4,3/4)]水平为6.40(4.70,8.75) ml/min,12个月后MTACcr [7.14(5.59,8.73) ml/min]较基线期明显升高(P＜0.05).与腹膜溶质转运功能稳定组相比,溶质转运功能增高组患者腹透透出液IL-6 AR明显升高[277.08(247.45,349.53) pg/min比263.18 (69.94,286.72) pg/min,P＜ 0.05],残肾功能较低[0.79(0,2.12) ml/min比1.70(0.39,3.38) ml/min,P＜0.05],尿量减少[225(0,600) ml/24 h比500(125,900) ml/24 h,P＜0.05],患者基线MTACcr较低[5.48(4.17,7.42) ml/min比7.00(5.46,9.76) ml/min,P＜0.05].Logistic回归分析结果显示高透出液IL-6 AR和低基线MTACcr是影响腹膜溶质转运功能远期改变的独立危险因素(均P＜0.05).结论腹腔局部炎性反应影响腹膜溶质转运功能的改变,腹腔IL-6水平是预测腹膜溶质转运功能改变的独立危险因素.
목적 탐토복막투석(복투)환자복강백세포개소6(IL-6)수평대복막용질전운공능적영향.방법 입선은정지속비와상복막투석(CAPD)환자128례,채용ELISA법측정복투투출액IL-6적농도,계산IL-6정현솔(appearance rate,AR),전첨성관찰환자기항용질전운면적계수(mass transfer area coefficient of creatinine,MTACcr)적변화.채용Logistic회귀분석투출액IL-6 AR대환자복막용질전운공능개변적영향.결과 입선환자적기선MTACcr중위수[M(1/4,3/4)]수평위6.40(4.70,8.75) ml/min,12개월후MTACcr [7.14(5.59,8.73) ml/min]교기선기명현승고(P＜0.05).여복막용질전운공능은정조상비,용질전운공능증고조환자복투투출액IL-6 AR명현승고[277.08(247.45,349.53) pg/min비263.18 (69.94,286.72) pg/min,P＜ 0.05],잔신공능교저[0.79(0,2.12) ml/min비1.70(0.39,3.38) ml/min,P＜0.05],뇨량감소[225(0,600) ml/24 h비500(125,900) ml/24 h,P＜0.05],환자기선MTACcr교저[5.48(4.17,7.42) ml/min비7.00(5.46,9.76) ml/min,P＜0.05].Logistic회귀분석결과현시고투출액IL-6 AR화저기선MTACcr시영향복막용질전운공능원기개변적독립위험인소(균P＜0.05).결론 복강국부염성반응영향복막용질전운공능적개변,복강IL-6수평시예측복막용질전운공능개변적독립위험인소.
Objective To evaluate the effect of dialysate interleukin-6 (IL-6),a marker of ongoing peritoneal inflammation,on the alteration of peritoneal solute transport rates (PSTRs) in stable continuous ambulatory peritoneal dialysis (CAPD) patients.Methods A total of 128 case of stable CAPD patients were enrolled in present study.IL-6 levels in the overnight effluent were determined by ELISA and IL-6 appearance rates (AR) were calculated.Mass transfer area coefficients of creatinine (MTACcr) were prospectively followed up.Logistic regression was used to examine the association between IL-6 AR and increased PSTRs.Results The MTACcr was significantly increased after 12 months follow-up [M(1/4,3/4),6.40(4.70,8.75) ml/min vs 7.14(5.59,8.73) ml/min,P＜ 0.05].Compared to the patients with stable PSTRs,the dialysate IL-6 AR in patients with increased PSTRs showed significantly higher [277.08(247.45,349.53) pg/min vs 263.18 (69.94,286.72) pg/min,P ＜0.05].Patients with increased PSTRs also had lower residual renal function [0.79(0,2.12) ml/min vs 1.70 (0.39,3.38) ml/min,P ＜ 0.05],less urine volume [225(0,600) ml/24 h vs 500(125,900) ml/24 h,P ＜ 0.05] and lower baseline MTACcr [5.48 (4.17,7.42) ml/min vs 7.00(5.46,9.76) ml/min,P ＜ 0.05]when compared to their counterparts with stable PSTRs.Logistic analysis showed that high dialysate IL-6 AR and low baseline MTACcr were independent risk factors for increasing peritoneal solute transport rate (P ＜ 0.05).Conclusion Intra-peritoneal inflammation significantly affects the alteration of PSTRs,and the dialysate IL-6 may be a predictor for increased PSTRs in PD patients.