Vaziri N D, Miyada D S, Kim I, Reid J, Ocariz J
Department of Medicine, University of California, Irvine.
Int J Artif Organs. 1990 Apr;13(4):223-7.
Serum levels of several commonly measured enzymes are abnormal in patients with end-stage renal disease (ESRD). In the present study we measured serum total LDH activity and LDH isoenzymes in a group of 25 ESRD patients shortly before, during, and immediately after hemodialysis. Baseline serum total LDH activity in the ESRD group was midly but significantly higher than that found in the normal control group. The observed elevation was associated with an isomorphic pattern. Single passage of blood through the extracorporeal apparatus led to a rise in total LDH, LDH-3, LDH-2 and LDH-4, a pattern consistent with release from the platelets. A steady increase was noted in total LDH, LDH-5 and LDH-1 of arterial blood during hemodialysis. This was thought to be due to ultrafiltration-induced hemoconcentration, enzyme release from the formed elements within the extracorporeal circuit and complement-mediated leukocyte activation and pulmonary leukostasis. These observations should be taken into consideration with regards to interpretation of LDH and LDH isoenzyme values and proper time of blood sampling in ESRD patients.
终末期肾病（ESRD）患者血清中几种常用检测酶的水平异常。在本研究中，我们对25例ESRD患者在血液透析前、透析期间和透析后即刻测定了血清总乳酸脱氢酶（LDH）活性及LDH同工酶。ESRD组的基线血清总LDH活性略高于正常对照组，但差异有统计学意义。观察到的升高与同型模式相关。血液单次通过体外装置导致总LDH、LDH-3、LDH-2和LDH-4升高，这种模式与血小板释放一致。血液透析期间动脉血总LDH、LDH-5和LDH-1持续升高。这被认为是由于超滤引起的血液浓缩、体外循环中血细胞成分释放酶以及补体介导的白细胞活化和肺白细胞淤滞所致。在解释ESRD患者的LDH及LDH同工酶值和正确的采血时间时应考虑这些观察结果。
