上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (5): 554-.

• 论著（临床研究） • 上一篇    下一篇

艾考糊精腹膜透析液对患者透析流出液中CA125水平的影响

林爱武, 钱家麒, 方 炜, 倪兆慧, 戴慧莉, 吴青伟   

  1. 上海交通大学 医学院仁济医院肾脏科 |上海市腹膜透析研究中心, 上海 200001
  • 出版日期:2010-05-25 发布日期:2010-05-28
  • 作者简介:林爱武（1967—）, 女, 主任医师, 博士生；电子信箱: linaiwu_sh@126.com。
  • 基金资助:

    上海市科委基金（08DZ1900501）；上海市教委基金（09YZ83）；上海交通大学博士创新基金（BXJ0916）

Effects of icodextrin dialysate on CA125 level in peritoneal effluent

LIN Ai-wu, QIAN Jia-qi, FANG Wei, NI Zhao-hui, DAI Hui-li, WU Qing-wei   

  1. Renal Division, Center for Peritoneal Dialysis Research, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200001, China
  • Online:2010-05-25 Published:2010-05-28
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 08DZ1900501；Shanghai Education Committee Foundation, 09YZ83；Shanghai Jiaotong University Foundation, BXJ0916

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摘要：

目的 前瞻性研究使用艾考糊精透析液后患者透析流出液中CA125水平的变化，探讨其对腹膜间皮细胞的影响。方法 选取以2.5%葡萄糖透析液夜间留腹的持续性非卧床腹膜透析（CAPD）患者作为研究对象，随机分为艾考糊精组（选择7.5%艾考糊精透析液夜间留腹）和对照组（仍以2.5%葡萄糖透析液夜间留腹），总治疗期为4周，每2周随访1次（用药后第14、28天）。观察和比较两组基线期和用药后第14、28天的夜间留腹净超滤量和腹膜肌酐清除率变化；测定两组基线期和用药后第28天的夜间留腹透析流出液中CA125水平，计算CA125呈现率。结果 54例CAPD患者入选，两组各27例。两组患者基线期各项指标比较差异均无统计学意义（P>0.05）。艾考糊精组用药后第14、28天的净超滤量和腹膜肌酐清除率均较基线期明显提高，且显著高于相应时间点的对照组（P<0.05)。艾考糊精组和对照组用药后第28天与基线期夜间留腹透析流出液CA125呈现率的差值分别为（1484.0±1571.6） U/h和（-222.1±1816.7）U/h，差异有统计学意义（P<0.01）。结论 与2.5%葡萄糖透析液相比，7.5%艾考糊精透析液能显著提高患者透析流出液中CA125水平，提示腹膜间皮细胞生成数量增加。

关键词: 腹膜透析, 癌抗原125, 超滤, 腹膜肌酐清除率, 腹膜间皮细胞

Abstract:

Objective To prospectively observe the changes of carbohydrate antigen 125 (CA125) level in peritoneal effluent after application of icodextrin dialysate, and investigate the effects of icodextrin on peritoneal mesothelial cells. Methods Patients undergoing continuous ambulatory peritoneal dialysis (CAPD) with 2.5% glucose dialysate were selected, and were randomly divided into icodextrin group (treatment with 7.5% icodextrin dialysate for night dwell) and control group (treatment with 2.5% glucose dialysate for night dwell). The therapeutic session lasted 4 weeks, and follow-up was conducted on 14 d and 28 d after treatment. Ultrafiltration volumes and peritoneal creatinine clearance of night dwell were measured at baseline and 14 d and 28 d after treatment. CA125 levels in peritoneal effluent of night dwell at baseline and 28 d after treatment were determined, and CA125 appearance was calculated. Results Fifty-four patients with CAPD were enrolled, with 27 in each group. There was no significant difference in baseline parameters between the two groups (P>0.05). Ultrafiltration volumes and peritoneal creatinine clearance of 14 d and 28 d after treatment in icodextrin group were significantly higher than baseline data, and were significantly higher than those in control group (P<0.05). The differences in CA125 appearance in peritoneal effluent of night dwell between 28 d after treatment and baseline were (1484.0±1571.6) U/h and (-222.1±1816.7) U/h in icodextrin group and control group, respectively (P<0.01). Conclusion Compared with 2.5% glucose dialysate, 7.5% icodextrin dialysate can significantly increase CA125 level in peritoneal effluent, indicating an increase in peritoneal mesothelial cell production.

Key words: peritoneal dialysis, cancer antigen 125, ultrafiltration, creatinine clearance, peritoneal mesothelial cell