Dimković N, Pejnović N, Radovanović Lj
Institute for Renal Diseases, Zvezdara Clinical Hospital Centre, Belgrade.
Srp Arh Celok Lek. 1996;124 Suppl 1:144-6.
Examination of the risk factors for peritonitis appearance in patients on chronic peritoneal dialysis is on great importance for better understanding of its therapy and prevention. The aim of the study was to confirm the significance of some local defense parameters of peritoneal space and its role in peritonitis incidence. The methodology was: radial immunodifussion (IgG), nephelometry (C3), ingestion of the yeast particles (phagocytosis) and bioassays for cytokine determination. The level of termostable opsonines (IgG) was significantly lower in patients with high peritonitis incidence. Also, TNF, IL6 and IL1 activity was elevated or very high in 42.1%, 57.8% and 47.3% in the same group of patients but almost unmeasurable in patients with low peritonitis incidence. Phagocytosis by peritoneal macrophages was similar in all patients and the level of termolabile opsonines was critically low in the peritoneal fluid of all patients. The presented differences in local defense parameters may partly explain the susceptibility to infection in some patients being on chronic peritoneal dialysis.
研究慢性腹膜透析患者腹膜炎发生的危险因素对于更好地理解其治疗和预防至关重要。本研究的目的是证实腹膜腔一些局部防御参数的意义及其在腹膜炎发病中的作用。方法包括:放射免疫扩散法(检测IgG)、散射比浊法(检测C3)、酵母颗粒摄取试验(吞噬作用)以及细胞因子测定的生物测定法。腹膜炎发生率高的患者中,耐热调理素(IgG)水平显著降低。同样,在同一组患者中,TNF、IL6和IL1活性分别有42.1%、57.8%和47.3%升高或非常高,但在腹膜炎发生率低的患者中几乎无法检测到。所有患者腹膜巨噬细胞的吞噬作用相似,所有患者腹膜液中不耐热调理素水平极低。局部防御参数的上述差异可能部分解释了一些慢性腹膜透析患者易感染的原因。