摘要：目的研究不同透析膜对维持性血液透析(MHD)患者外周血转化生长因子β1(TGP－β1)及单核细胞趋化蛋白－1(MCP－1)水平的影响。方法应用酶联免疫法(ELISA)测定长期用铜仿膜(CU)和聚砜膜(PSU)透析患者外周血TGF-β1及MCP-1水平。结果与正常对照组[(50.2±5.7)ng／ml]相比，CU[(82.9±9.8)ng／ml]和P5U[(65.5±9.2)ng／ml]透析患者外周血TGF-β1水平明显增加(P＜0.01，P＜0.05)，但PSU组与CU组相比，外周血TGF-β1水平明显下降(P＜0.05)。MHD患者外周血MCP-1水平也有所增加，其中PSU组[(72.2±5.3)pg／ml]与对照组[(56.4±7.8)ng／ml]相比有显著性差异(P＜0.05)。另外，CU与PSU组内TGF-β1与MCP-1水平之间均呈明显负相关(r=-0.5425与-0.4562，P均＜0.05)。结论MHD可增加尿毒症患者TGF-β1与MCP-1水平，但透析膜类型对它们的影响有所不同。

Effects of dialyzed membrane on TGF-β1 and MCP-1 plasma levels in hemodialysis patients

gU Yong,WU Yonggui,ZHOU Jianghua(Division of Nephrology, Huashan Hospital, Shanghai Medical University, Shanghai 200040, China)

Abstract：Objective To investigate effects of different dialyzed membrane on transforming growth factor(TGF-β1) and monocyte chemoattractant protein(MCP-1) plasma levels in maintenance hemodialysis(MHD) patients. Methods The plasma concentrations of TGF-β1 and MCP-1 were measured by ELISA assay in well-matched uremic patients undergoing maintenance hemodialysis with either cuprophane (CU, n=27) or polysulfone(PSU, n=25). Results Compared with controls (50.2±5.7 ng/ml), the patients on CU (82.9±9.8 ng/ml) and PSU (65.5±6.5 ng/ml)membranes dialysis had significantly higher mean TGF-β1 concentration (P＜0.01, P＜0.05) . However, the patients on PSU membrane dialysis had significantly lower mean TGF-β1 concentrations in contrast with CU membrane dialysis. MCP-1 plasma levels were also higher in patients dialyzed with PSU(72.2±5.3 pg/ml) than in controls(56.4±7.8) . In contrast to TGF-β1, the increase was greater in pSU-treated patients than in CU-theated patients. In addition, negative correlation was observed between the plasma levels of TGF-β1 and MCP-1 in patients dialyzed with CU or pSU. Conclusions MHD is associated with the increase of plasma levels of TGF-β1 and MCP-1. Moreover, the type of dialysis membrane has different effects on plasma levels of TGF-β1 and MCP-1.

Keywords：Dialyzed membrane; Transforming growth factor; Monocyte chemoattractant protein参考文献：

［1］Massague J. Transforming growth factor-β family. Annu Rev, 1990, 6: 597-640.

［2］Anderson J, Briefel G, Jones JM, et al. Effect of acetate dialysate on transforming growth factor-β1, interleukin, and β2-microglohulin plasma levels. Kindey Int, 1991, 40: 1100-1117.

［3］Jiang X, Kanai H, Shigehara T, et al. Metabolism of transforming growth factor-β in patients receiving hemodialysis especially those with renal osteodystrophy. Renal Failure, 1998, 20: 135-145.

［4］Rovin BH, Doe N, Tan LC. Monocyte chemoattractant protein levels in patients with glomerular disease. Am J Kidney dis, 1996, 27: 640-646.

［5］Chantry D, Turner M, Abrey E, et al. Modulation of cytokine production transforming growth factor β ?J immunol, 1989, 142: 4295-4300.

［6］Shull MM. Ormsbv I. Kier AB. et al. Tareeted disruntion of the mouse transforming growth factor β1 gene results in multifocal inflammatory disease. Nature, 1992. 359: 692-699.

［7］Mege JL, Capo C, Purgus R, et al. Monocyte production of transforming growth factor β in long-term hemodialysis: modulation by hemodialysis membranes. Am J Kidney Dis, 1996, 28: 395-399.

［8］Schindler R, Lonnemann G, Shaldon S, et al. Transcription not synthesis of interleukin 1 and tumor necrosis factor by complement. Kidney int, 1990, 37;85-93.

［9］Welch GR, Wong HL, Wahl SM, et al. Selective induction of FcRIII on human monocytes by transforming growth factor β. J immunol, 1990, 144: 3444-3448.

收稿日期：1999-08-20