Maejima M, Takahashi S, Hatano M
Second Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 1991 Feb;33(2):201-12.
Studies were performed on the platelet aggregation (PA) in patients with chronic renal failure (CRF) and normal subjects (NS). The PA was investigated in the whole blood by the electrical impedance method. The concentrations of plasma (P-) and erythrocyte (E-) guanidinosuccinic acid (GSA) and methylguanidine (MG) in uremic patients with CRF were determined by high performance liquid chromatography. GSA and MG are guanidino compounds (GC) and have been widely shown to act as uremic toxins. The effects of GSA and/or MG on the PA of NS were also investigated. The results showed that the PA of conservative therapy patients with CRF was significantly lower than that of NS, while the PA of hemodialysis (HD) patients was improved. The PA of continuous ambulatory peritoneal dialysis (CAPD) patients was rather high and the possibility of sugar and lipid metabolic disorders was suggested as the cause. The concentrations of P- and E-GSA and MG in uremic patients with CRF were increased. But there were no significant correlations between the PA and the concentrations of GSA and MG. In vitro, GSA and/or MG at a high concentration exerted a significant inhibitory effect, while at a low concentration they showed a lesser inhibitory effect on the PA. In conclusion, based on their inhibition of the PA in patients with CRF, the dialyzable materials, GSA and MG, are considered to represent active uremic toxins.
对慢性肾衰竭（CRF）患者和正常受试者（NS）的血小板聚集（PA）进行了研究。采用电阻抗法在全血中检测PA。通过高效液相色谱法测定CRF尿毒症患者血浆（P-）和红细胞（E-）中胍基琥珀酸（GSA）和甲基胍（MG）的浓度。GSA和MG是胍基化合物（GC），已被广泛证明可作为尿毒症毒素。还研究了GSA和/或MG对NS的PA的影响。结果显示，CRF保守治疗患者的PA显著低于NS，而血液透析（HD）患者的PA有所改善。持续性非卧床腹膜透析（CAPD）患者的PA相当高，提示糖脂代谢紊乱可能是原因。CRF尿毒症患者P-和E-GSA及MG的浓度升高。但PA与GSA和MG的浓度之间无显著相关性。在体外，高浓度的GSA和/或MG对PA有显著抑制作用，而低浓度时它们对PA的抑制作用较小。总之，基于它们对CRF患者PA的抑制作用，可透析物质GSA和MG被认为是活性尿毒症毒素。
