Fernandez de Castro M, Selgas R, Jimenez C, Auxiliadora Bajo M, Martinez V, Romero J R, de Alvaro F, Vara F
Hospital La Paz, Facultad de Medicina, Universidad Autonoma, Madrid, Spain.
Perit Dial Int. 1994;14(3):265-70.
To study the relationship between peritoneal effluent cells and infection rate and to relate this population with functional characteristics.
Prospective, longitudinal, and comparative study.
Outpatient continuous ambulatory peritoneal dialysis (CAPD) unit of a university medical center.
Seventy-one uninfected patients, treated for 0-156 months on CAPD, in stable condition were studied (33 female, 38 male).
Nocturnal peritoneal effluent (NPE) was drained with EDTA (2.5 mmol/L) at 37 degrees C and centrifuged at 2500 rpm for 9 minutes.
Accumulated peritoneal inflammation days/year and ultrafiltration/diffusion (mass transfer coefficients (MTCs) for small molecules) capacities were recorded. Cellular count (cells/night) was performed using a Neubauer chamber. Macrophage function was assessed by cytochemical (lysosomal enzyme content: ANAE, beta-glucuronidase, acid phosphatase) and immunohistochemical procedures (expression of membrane antigens, CD4, 11b, 11c, 14, 16, 25, 35, and 71).
The macrophage is the most frequently appearing cell in the NPE. Cell count decreases over time on CAPD (from 20 x 10(6) to 5 x 10(6) after the first year). Intrapatient variability was low, but interpatient differences were marked. Mesothelial cell count remained stable over time (0.25-0.5 x 10(6)). Four of our patients showed a "transforming" change in these cells. Previous incidence of peritonitis and values of functional measurements did not correlate with cell count or expressions of macrophage function (lysosome enzyme content and percentage of cells expressing different membrane antigens).
There is difficulty interpreting the results on peritoneal effluent cells and their relationship with the incidence of peritonitis and functional characteristics of the peritoneum. No definite conclusions can be drawn other than the great interpatient and intrapatient variability. The presence of abnormal peritoneal cells with undetermined origin and function suggests the need for periodic studies of peritoneal effluent cells on long-term CAPD patients.
研究腹膜透析液细胞与感染率之间的关系，并将该细胞群体与功能特性联系起来。
前瞻性、纵向和比较性研究。
某大学医学中心的门诊持续性非卧床腹膜透析（CAPD）单元。
71例未感染患者，接受CAPD治疗0至156个月，病情稳定（33例女性，38例男性）。
夜间腹膜透析液（NPE）在37℃下用乙二胺四乙酸（2.5 mmol/L）引流，并以2500转/分钟的速度离心9分钟。
记录每年累积的腹膜炎症天数和超滤/扩散（小分子物质的质量传递系数（MTCs））能力。使用血细胞计数板进行细胞计数（细胞数/夜）。通过细胞化学（溶酶体酶含量：ANAE、β-葡萄糖醛酸酶、酸性磷酸酶）和免疫组织化学方法（膜抗原CD4、11b、11c、14、16、25、35和71的表达）评估巨噬细胞功能。
巨噬细胞是NPE中最常见的细胞。在CAPD治疗过程中，细胞计数随时间下降（第一年从20×10⁶降至5×10⁶）。患者内变异性低，但患者间差异明显。间皮细胞计数随时间保持稳定（0.25 - 0.5×10⁶）。我们的4例患者在这些细胞中出现了“转化”变化。既往腹膜炎发生率和功能测量值与细胞计数或巨噬细胞功能表达（溶酶体酶含量和表达不同膜抗原的细胞百分比）无关。
解读腹膜透析液细胞结果及其与腹膜炎发生率和腹膜功能特性之间的关系存在困难。除了患者间和患者内的巨大变异性外，无法得出明确结论。存在来源和功能未确定的异常腹膜细胞提示需要对长期CAPD患者定期进行腹膜透析液细胞研究。
