[透析儿童的血浆氨基酸：血液透析与持续性非卧床腹膜透析的比较]

[Plasma amino acids in dialyzed children: comparison of hemodialysis and continuous ambulatory peritoneal dialysis].

作者信息

Perfumo F, Verrina E, Romano C, Cerone R, Caruso U, Gusmano R

出版信息

Pediatr Med Chir. 1986 May-Jun;8(3):341-5.

Abstract

Plasma protein and amino acid concentrations have been reported to be abnormal in patients with chronic renal failure, whether on conservative or regular dialysis treatment. These abnormalities may be related to impaired protein and amino acid metabolism associated with uremia, to dietary deficiencies of calories and proteins or to amino acid and protein losses due to peritoneal dialysis or hemodialysis. Plasma free amino acid concentrations were evaluated in 17 children undergoing hemodialysis (HD) and 13 children treated by continuous ambulatory peritoneal dialysis (CAPD). Plasma levels of free amino acids showed a reduction of EAA and of the ratio EAA/NEAA. There were some abnormalities in plasma amino acid concentrations; these included decreased levels of valine, threonine, lysine, serine, tyrosine, arginine, alpha-ABA. Aspartate, glycine, citrulline, and, only in HD, cystine and methionine were increased. Plasma protein and amino acid concentrations in CAPD patients are similar to those found in HD patients; thus they result poorly affected by different dialysis techniques and the uremic state itself seems to play a more decisive role.

摘要

据报道，无论是接受保守治疗还是定期透析治疗的慢性肾衰竭患者，其血浆蛋白和氨基酸浓度均异常。这些异常可能与尿毒症相关的蛋白质和氨基酸代谢受损、热量和蛋白质的饮食缺乏，或腹膜透析或血液透析导致的氨基酸和蛋白质流失有关。对17名接受血液透析（HD）的儿童和13名接受持续性非卧床腹膜透析（CAPD）治疗的儿童的血浆游离氨基酸浓度进行了评估。血浆游离氨基酸水平显示必需氨基酸（EAA）及EAA/非必需氨基酸（NEAA）比值降低。血浆氨基酸浓度存在一些异常；这些异常包括缬氨酸、苏氨酸、赖氨酸、丝氨酸、酪氨酸、精氨酸、α-氨基丁酸（alpha-ABA）水平降低。天冬氨酸、甘氨酸、瓜氨酸，且仅在血液透析患者中，胱氨酸和蛋氨酸水平升高。CAPD患者的血浆蛋白和氨基酸浓度与HD患者相似；因此，不同的透析技术对其影响不大，尿毒症状态本身似乎起更决定性的作用。