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慢性病和血液透析中的接触系统 - 一个横截面研究
Yaseelan Palarasah1, Rikke Borg2, Else-Marie Bladbjerg3
1Department of Cancer and Inflammation Research, Institute for Molecular Medicine, University of Southern Denmark, Odense, Denmark; Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark; Department of Clinical Biochemistry, Unit for Thrombosis Research, University Hospital of Southern Denmark, Esbjerg, Denmark.
在经过血液透析 (HD) 或腹腔透析 (PD) 的慢性病 (CKD) 患者中,接触系统的激活发生变化,显示卡利克林生成减少,但HD不会激活接触系统 (CAS). 进一步的研究应该探索CKD中CAS,而不依赖于透析.
科学领域:
- 免疫学 免疫学 免疫学
- 血液学 血液学 血液学
- 腎臟病學 (nephrology) 是一種醫學.
背景情况:
- 接触激活系统 (CAS) 在免疫和凝血中起作用.
- 在慢性病 (CKD) 和透析中CAS的参与是已知的,但不太了解.
- 相互矛盾的数据需要澄清在接受不同脏替代疗法的CKD患者中CAS激活的情况.
研究的目的:
- 为了比较CKD患者的CAS激活在接受血液透析 (HD) 和腹腔透析 (PD) 的患者.
- 评估与健康对照组相比,在非透析的CKD患者中CAS激活.
- 为了评估单个HD会话对CAS标志物的影响,从透析前到透析后.
主要方法:
- 从106名HD患者,40名PD患者,60名CKD患者和80名健康对照患者的血液样本进行截面分析.
- 测量CAS成分 (XII因子,前卡利克林,高分子量基因素,切割的HK,C1抑制剂) 和功能性卡利克林生成.
- 使用线性回归和混合模型对HD患者进行透析前和后CAS评估.
主要成果:
- 与其他组相比,HD患者表现出改变的prekallikrein,XII因子和裂开的HK水平.
- HD患者的C1抑制剂增加和功能性kallikrein生成减少,类似于PD和CKD患者与对照组.
- 在HD程序本身中没有发现CAS激活的证据.
结论:
- 慢性病,特别是HD或PD,与功能性kallikrein生成减少和CAS成分改变有关,表明正在进行的CAS激活.
- 在血液透析过程中没有显著的XII因子介导的CAS激活.
- 未来的研究应该独立于透析方式,调查CAS在CKD中的作用.
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