Niemczyk Stanisław, Matuszkiewicz-Rowińska Joanna, Szamotulska Katarzyna, Niemczyk Longin, Kulicki Paweł, Ostrowski Grzegorz, Zalewska-Waśniewska Anna, Sitkowska-Kurzec Zofia
Oddział Chorób Wewnetrznych ze Stacja Dializ SZP ZOZ w Wołominie.
Pol Arch Med Wewn. 2006 Dec;116(6):1137-43.
Determination of circadian of prolactine (PRL) profile and its relationship to selected clinical and laboratory indices in end-stage renal disease (ESRD) patients undergoing hemodialysis, peritoneal dialysis as well as those in predialysis period was the aim of the study. Investigations were carried out in 38 patients with ESRD aged 36 to 79 yr. (medium 59 +/- 11 yr.), (20 male, 18 female, 7 treated with peritoneal dialysis, 25 undergoing hemodialysis, 6 in predialysis period) and the control group consisting of 7 healthy volunteers (4 male and 3 female). Serum concentration of PRL was evaluated at 3:00, 7:00, 12:00, 18:00, 22:00. The influence of different dialysis methods, blood concentration of parathormone, hemoglobin, total protein, erytropoietin (EPO), C-reactive protein, EPO therapy and duration of dialysis therapy on the PRL profile was analyzed. Results were analyzed according to medium obtained values of daily PRL profiles and individual indexes of variation of the daily concentration. Impaired circadian PRL profile was found in the all of followed groups comparing to the control, which was based on flatting of the curve and decreasing of the nightly pick of secretion PRL. None of analyzed factors had normalized the PRL profile curve.
The PRL profile in ESRD patients treated with hemodialysis, peritoneal dialysis and in predialysis period is changed. The PRL profile curve is flatted and there was no night pick of PRL secretion in the patients. PRL level was shown to increase with progress of the disease, and the highest levels were in hemodialysed patients. EPO treatment, general appearance improvement, increased hemoglobin level and any of studied different dialysis method did not normalize the altered PRL profile.
本研究旨在测定接受血液透析、腹膜透析的终末期肾病（ESRD）患者以及透析前阶段患者催乳素（PRL）的昼夜节律及其与选定临床和实验室指标的关系。对38例年龄在36至79岁（平均59±11岁）的ESRD患者（20例男性，18例女性，7例接受腹膜透析治疗，25例接受血液透析，6例处于透析前阶段）以及由7名健康志愿者（4名男性和3名女性）组成的对照组进行了调查。在凌晨3:00、7:00、12:00、18:00、22:00评估血清PRL浓度。分析了不同透析方法、甲状旁腺激素血浓度、血红蛋白、总蛋白、促红细胞生成素（EPO）、C反应蛋白、EPO治疗以及透析治疗时长对PRL昼夜节律的影响。根据每日PRL昼夜节律的中位数获得值和每日浓度的个体变异指标对结果进行分析。与对照组相比，在所有随访组中均发现PRL昼夜节律受损，这基于曲线变平以及夜间PRL分泌峰值降低。所分析的因素均未使PRL昼夜节律曲线恢复正常。
接受血液透析、腹膜透析治疗以及处于透析前阶段的ESRD患者的PRL昼夜节律发生改变。PRL昼夜节律曲线变平，患者无PRL分泌的夜间峰值。PRL水平随疾病进展而升高，血液透析患者的PRL水平最高。EPO治疗、总体状况改善、血红蛋白水平升高以及任何一种所研究的不同透析方法均未使改变的PRL昼夜节律恢复正常。
