神经递质在尿毒症性脑病发生中的作用。

The role of neurotransmitters in the genesis of uremic encephalopathy.

作者信息

Biasioli S, D'Andrea G, Chiaramonte S, Fabris A, Feriani M, Ronco C, Borin D, Brendolan A, La Greca G

出版信息

Int J Artif Organs. 1984 Mar;7(2):101-6.

Abstract

To classify the influence of neurotransmitters in the genesis of uremic encephalopathy we studied cerebrospinal fluid (CSF) and plasma (P) amino acid (AA) concentration, in patients undergoing various dialytic treatments (hemodialysis = HD, intermittent and continuous peritoneal dialysis = IPD and CAPD). HD causes a significant decrease in CSF/P ratios of branched chain AA (BCAA) and a significant increase in CSF Glycine/Valine ratio, suggesting an augmented brain uptake of Glycine at detriment of Valine. In IPD the general trend of Aromatic AA/BCAA ratio suggests a preferential transport of Aromatic AA through the blood brain barrier. The differences between IPD and HD are confirmed by data concerning metabolites of Serotonin and Dopamine: CSF concentrations of 5- Hydroxyindoleacetic acid and Homovanillic acid are low in HD but high in IPD. So, a reduced (in HD) and an increased (in IPD) activity of monoamine systems could be at the basis of some neurological disturbances appearing in uremia.

摘要

为了分类神经递质在尿毒症性脑病发生过程中的影响，我们研究了接受各种透析治疗（血液透析=HD、间歇性和持续性腹膜透析=IPD和CAPD）患者的脑脊液（CSF）和血浆（P）氨基酸（AA）浓度。血液透析导致支链氨基酸（BCAA）的脑脊液/血浆比值显著降低，脑脊液甘氨酸/缬氨酸比值显著升高，这表明甘氨酸对脑的摄取增加，而缬氨酸摄取减少。在间歇性腹膜透析中，芳香族氨基酸/支链氨基酸比值的总体趋势表明芳香族氨基酸优先通过血脑屏障转运。关于血清素和多巴胺代谢物的数据证实了间歇性腹膜透析和血液透析之间的差异：5-羟吲哚乙酸和高香草酸的脑脊液浓度在血液透析中较低，但在间歇性腹膜透析中较高。因此，单胺系统活性降低（在血液透析中）和升高（在间歇性腹膜透析中）可能是尿毒症中出现的一些神经紊乱的基础。