血清脂肪酶在接受血液透析患者中的意义。

Significance of serum lipase in patients undergoing hemodialysis.

作者信息

Shibasaki T, Matsuda H, Ohno I, Gomi H, Nakano H, Misawa T, Abe S, Ishimoto F, Kisugi R, Ikeda K, Machida K, Sakai O

机构信息

Department of Second Internal Medicine, Jikei University School of medicine, Tokyo, Japan.

出版信息

Am J Nephrol. 1996;16(4):309-14. doi: 10.1159/000169015.

DOI:10.1159/000169015

PMID:8739284

Abstract

Serum levels of lipase (Lp) during the end of the dialysis showed a significant increase after the administration of heparin in hemodialysis patients. However, serum Lp levels were not increased after the administration of the anti-coagulant nafamostat mesylate in hemodialysis patients. Serum levels of Lp were significantly correlated with serum levels of lipoprotein lipase (LPL), hepatic triglyceride lipase (H-TGL) and nonesterified fatty acid (NEFA) 20 min after the administration of heparin during maintenance hemodialysis. Lp activity did not appear with the NEFA ligand for determining the NEFA activity. Inhibitors of LPL and H-TGL reduced the measured Lp activity in vitro. The main mechanism of elevated measured serum Lp activity in hemodialysis patients was determined to be cross-reactivity with LPL or H-TGL. Furthermore, measurement of Lp may be a method for determining optimal coagulation time in patients with hemodialysis.

摘要

血液透析患者在透析结束时的血清脂肪酶（Lp）水平在给予肝素后显著升高。然而，血液透析患者在给予抗凝血剂甲磺酸萘莫司他后血清Lp水平并未升高。在维持性血液透析期间给予肝素20分钟后，血清Lp水平与脂蛋白脂肪酶（LPL）、肝甘油三酯脂肪酶（H-TGL）和非酯化脂肪酸（NEFA）的血清水平显著相关。Lp活性在用于测定NEFA活性的NEFA配体存在时未出现。LPL和H-TGL的抑制剂在体外降低了测得的Lp活性。血液透析患者测得的血清Lp活性升高的主要机制被确定为与LPL或H-TGL的交叉反应性。此外，Lp的测量可能是一种确定血液透析患者最佳凝血时间的方法。