Dreisbach A W, Hendrickson T, Beezhold D, Riesenberg L A, Sklar A H
Department of Medicine, United Health Services Hospitals, Binghamton, New York, USA.
Int J Artif Organs. 1998 Feb;21(2):83-6.
Postdialysis fatigue (PDF) has been ascribed to excessive ultrafiltration and decline in osmolality during hemodialysis. We evaluated the potential role for the sommogenic cytokines, interleukin-1 beta (IL-1beta) and tumor necrosis factor alpha (TNFalpha), in the genesis of PDF Patients dialyzing with cuprophane membrane were assigned to PDF (N=25) and non-PDF (N=25) groups based on a fatigue index questionnaire. Pre- and postdialysis samples were obtained from 3 consecutive treatments and later assayed for serum levels of IL-1beta and TNFalpha by ELISA. Our results show significant intradialytic elevation of TNFalpha in both non-PDF groups (non-PDF: pre- 3.36+/-0.80 pg/ml to post 3.75+/-0.88 pg/ml, p<0.04; PDF: pre- 5.95+/-0.80 pg/ml to post- 8.66-/+1.35 pg/ml, p<0.02). The degree of intradialytic augmentation was significantly greater for TNFalpha in the PDF group (46+/-18% vs 11+/-5%; p<0.03). There were no significant intradialytic changes in serum levels of IL-1beta in either the PDF or non-PDF groups. There also were no significant differences in dialysis-related body weights, systolic blood pressures, or osmolalities. These findings suggest that TNFalpha may be involved in the pathogenesis of PDF.
透析后疲劳（PDF）被认为与血液透析期间超滤过多和渗透压下降有关。我们评估了促睡眠细胞因子白细胞介素-1β（IL-1β）和肿瘤坏死因子α（TNFα）在PDF发生过程中的潜在作用。根据疲劳指数问卷，将使用铜仿膜进行透析的患者分为PDF组（N = 25）和非PDF组（N = 25）。从连续3次治疗中获取透析前和透析后的样本，随后通过酶联免疫吸附测定法检测血清中IL-1β和TNFα的水平。我们的结果显示，两个非PDF组中TNFα在透析期间均显著升高（非PDF组：透析前3.36±0.80 pg/ml至透析后3.75±0.88 pg/ml，p<0.04；PDF组：透析前5.95±0.80 pg/ml至透析后8.66±1.35 pg/ml，p<0.02）。PDF组中TNFα的透析期间升高程度显著更大（46±18%对11±5%；p<0.03）。PDF组和非PDF组中血清IL-1β水平在透析期间均无显著变化。透析相关体重、收缩压或渗透压也无显著差异。这些发现表明TNFα可能参与了PDF的发病机制。
