Klin M, Waluga M, Rudka R, Madej A, Janiszewska M, Grzebieniak E, Wesolowky A
Department of Clinical Pharmacology, Division of Nephrology-Miners' Hospital, Bytom.
Boll Chim Farm. 1998 Sep;137(8):306-13.
We have studied the effects of handgrip on plasma levels of catecholamines, neuropeptide Y (NPY), and leu-enkephalin before and after hemodialysis of uremic patients. A cuprophan dialyzer was used. We found, that dopamine level was higher in uremia group before hemodialysis both during rest (0.38 +/- 0.39 pmol/ml) and handgrip (1.13 +/- 1.00 pmol/ml) compared to control (0.17 +/- 0.19, and 0.66 +/- 0.83 pmol/ml respectively). Hemodialysis leads to further increase of its level (0.49 +/- 0.35 pmol/ml) at rest. Epinephrine level was almost the same in uremic patients before (0.43 +/- 0.51 pmol/ml) and after dialysis (0.46 +/- 0.60) as in control subjects (0.41 +/- 0.37 pmol/ml) during the rest. Its level measured after the handgrip was the highest in uremic group after dialysis (2.10 +/- 2.00 pmol/ml), significantly lower before dialysis (1.26 +/- 0.85 pmol/ml), and the lowest in control group (0.78 +/- 0.43 pmol/ml). Norepinephrine level were very similar in uremic group before dialysis (1.54 +/- 1.05 pmol/ml), after dialysis (1.79 +/- 1.29 pmol/ml) and in control group (1.46 +/- 1.06 pmol/ml) during the rest. During the handgrip test its level was higher in uremic group after hemodialysis than before it (adequate values 8.78 +/- 4.61 and 6.70 +/- 4.74 pmol/ml). The difference between uremia group before dialysis and control group did not reach significance. The level of NPY has the tendency to increase in uremic patients. Dialysis leads to following increase of its level, but the changes did not reach the significance both in rest and handgrip. Leu-enkephalin level was higher in uremic group (9.21 +/- 7.62 pmol/ml) compared to control (5.22 +/- 1.53 pmol/ml). We observed non-significant fall of this level after dialysis (6.79 +/- 4.76 pmol/ml). We found the same tendency during the handgrip, and the changes were significant.
uremia per se leads to increase the level of dopamine and leu-enkephaline during the rest and handgrip, but the level of epinephrine only during the handgrip; dialysis leads to further increase of dopamine during the rest, but epinephrine, norepinephrine and leu-enkephaline only during the handgrip.
我们研究了尿毒症患者血液透析前后握力对血浆儿茶酚胺、神经肽Y（NPY）和亮氨酸脑啡肽水平的影响。使用了铜仿膜透析器。我们发现，与对照组（静息时分别为0.17±0.19和0.66±0.83 pmol/ml，握力时分别为0.17±0.19和0.66±0.83 pmol/ml）相比，尿毒症组血液透析前静息时（0.38±0.39 pmol/ml）和握力时（1.13±1.00 pmol/ml）多巴胺水平更高。血液透析导致静息时其水平进一步升高（0.49±0.35 pmol/ml）。尿毒症患者透析前（0.43±0.51 pmol/ml）和透析后（0.46±0.60）静息时肾上腺素水平与对照组（0.41±0.37 pmol/ml）几乎相同。握力后测量的其水平在透析后尿毒症组最高（2.10±2.00 pmol/ml），透析前显著降低（1.26±0.85 pmol/ml），在对照组最低（0.78±0.43 pmol/ml）。尿毒症组透析前（1.54±1.05 pmol/ml）、透析后（1.79±1.29 pmol/ml）和对照组静息时（1.46±1.06 pmol/ml）去甲肾上腺素水平非常相似。在握力试验期间，血液透析后尿毒症组其水平高于透析前（合适值分别为8.78±4.61和6.70±4.74 pmol/ml）。透析前尿毒症组与对照组之间的差异未达到显著水平。尿毒症患者NPY水平有升高趋势。透析导致其水平进一步升高，但静息和握力时的变化均未达到显著水平。尿毒症组亮氨酸脑啡肽水平（9.21±7.62 pmol/ml）高于对照组（5.22±1.53 pmol/ml）。我们观察到透析后该水平有不显著下降（6.79±4.76 pmol/ml）。握力时我们发现了相同趋势，且变化显著。
尿毒症本身导致静息和握力时多巴胺和亮氨酸脑啡肽水平升高，但仅握力时肾上腺素水平升高；透析导致静息时多巴胺进一步升高，但仅握力时肾上腺素、去甲肾上腺素和亮氨酸脑啡肽水平升高。
