慢性肾功能衰竭时Leptin及临床意义研究.pdfVIP

Thestudyontheisolationandpurification o f urem lc highmolecules Background:Uremictoxinsretentionisoneoftheimportantmechanismsof chronicrenalfailure(CRF).InCRFpatients,theaccumulation:ofhighamoutof toxicalmaterialsresultinaseries Dialysiscanonly ofphysiologicaldisorders. partlyremovessmallandsomemiddlemoleculartoxinsandisnotveryeffective tocorrecturemicmalnutrition,anemia,hypertention.Thesephenomenasug- gestedthattherearetoxinswithhighermolecules，whichcannotberemovedby dialysis,contributingtothediseases.Themolecularwhichmolecularweightis highethan5KDiscalledhighmolecularmaterial.Manyeffortshavebeenoniso- latingthesematerialsandtheususalabnormalgradientsisbetween5and94KD OurstudydesigntoisolatenewhighmolecularmaterialsfromCRFpatients serumusingPAGE. Methods:Separatethegradientsofserumformuremicpatientsandnormalvol- unteerbyPAGE.Afterstainedbysilverstaining,weanalysistheabnormal bandsanddetermineitsmolecularweight. Results:Twoabnormalbandswerefoundinuremicpatientsserum,whichisob- viouslyhigherconcentrationsthannormalcontrolgroup.Theirmolecularweight areabout16KDand41KDaccordingtomolecularstandard.Thepositiverateare 77.5%and62.5respectively. Conclusion:Inuremicserum,thereareatleasttwoabnormalgradients,whose molecularweightis16KDand41KD.Wewillfurtherourstudytoclarifytheir biologicalfunctionandtheirroleinthepathogenesisofuremicrelateddisorders. 一 2 一 前 言 慢性肾功能不全是临床常见病症，表现为代谢异常与脏器功能紊乱等。引起 其病理生理紊乱的重要机制之一即是由于肾脏排泄功能障碍导致尿毒症毒素储 留，肾脏替代疗法主要包括透析疗法和肾移植。而透析疗法的效果主要取决于尿 毒症毒素被清除的质和量，但迄今尿毒症毒素远未被完全阐明。习J质上尿毒症毒 素按其分子量大小分为三大类:即小分子物质(分子量300D)、中分子物质(分子 量300D-5000D)和大分子物质(分子量5000D)11a 小分子物质包括尿素、肌fF等，但人们发现接受血透治疗的患者，尽管大量小 分子物质被清除，但贫血、心血管并发症和周围神经炎等并未完全缓解。而长期腹 透患者，尽管小分子清除不佳，但上述并发症的控制较好川。于是推测可能有分子 量比小分子物质大的一些物质在尿毒症的某些病理生理紊乱发生中起重要作用， 并于1972年提出了“中分子学说”[z7随后发现了一系列所谓的中分子物质，如甲 基肌和其它肌类物质、硫酸叫噪酚、马尿酸、肤类、甲状旁腺素、Nz