Page 70 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第41卷第11期
·1632 · Journal of Nanjing Medical University（Natural Sciences） 2021年11月

·临床研究·

腹腔白介素36对持续不卧床腹膜透析患者腹膜溶质转运特性

和预后的影响

李建中，徐德宇，周 玲，沈 蕾，卢国元 *

苏州大学附属第一医院肾内科，江苏 苏州 215006

［摘 要］ 目的：探讨腹腔白介素（interleukin，IL）⁃36水平对腹膜透析患者腹膜溶质转运特性以及预后的预测价值。方法：收
集2018年6月—2019年12月在苏州大学附属第一医院腹膜透析中心规律随访的111例持续不卧床腹膜透析患者（continuous
ambulatory peritoneal dialysis，CAPD）过夜留腹的腹透流出液，并抽取静脉血。依据腹膜平衡试验（peritoneal equilibration test，
PET）结果将患者分为高/高平均转运（H/HA）组以及低/低平均转运（L/LA）组。收集患者基本资料，随访17个月，记录随访患者
不良事件。采用酶联免疫吸附测定（enzyme linked immunosorbent assay，ELISA）法检测患者腹透流出液以及血清中IL⁃36α、IL⁃
36β、IL⁃36γ的水平。通过Pearson 相关分析、Logistic 回归分析评价IL⁃36对腹膜溶质转运特性以及腹膜透析患者预后的预测
价值。结果：CAPD患者中腹透流出液IL⁃36α、IL⁃36γ与PET试验中D/P Cr呈正相关（r=0.51，P＜0.001；r=0.55，P＜0.001），与D/
D0 呈负相关（r=-0.40，P＜0.001；r=-0.44，P＜0.001）。IL⁃36α 呈现率（appearance rate，AR）及 IL⁃36γ AR 是腹膜转运特性的独
立预测因素（OR=1.40，P=0.001；OR=1.08，P=0.016）。受试者工作特征曲线（receiver operating characteristic，ROC）曲线下面积
（area under curve，AUC）结果显示，IL⁃36α AR为0.75（95%CI：0.66~0.84），IL⁃36γ AR为0.79（95%CI：0.70~0.88）。腹透流出液IL
⁃36α AR也是CAPD患者不良事件发生的独立预测因素（OR=1.21，P=0.006），AUC为0.76（95%CI：0.64~0.89）。结论：CAPD患
者中腹透流出液IL⁃36可能是预测腹膜溶质转运特性和患者预后的潜在生物学标志物。
［关键词］ 腹膜透析；白介素⁃36；腹膜溶质转运特性
. ［中图分类号］ R692.5 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）11⁃1632⁃07
doi：10.7655/NYDXBNS20211111

Value of measurement of interleukin ⁃ 36 in peritoneal dialysis effluent in predicting the
peritoneal solute transport rate and prognosis in continuous ambulatory peritoneal dialysis
patients

LI Jianzhong，XU Deyu，ZHOU Ling，SHEN Lei，LU Guoyuan *
Department of Nephrology，the First Affiliated Hospital of Soochow University，Suzhou 215006，China

［Abstract］ Objective：This study aims to evaluate the value of measurement of interleukin（IL）⁃36 in peritoneal dialysis effluent in
predicting the peritoneal solute transport rate and prognosis in continuous ambulatory peritoneal dialysis（CAPD）patients. Methods：
From June 2018 to December 2019，a total of 111 CAPD patients in peritoneal dialysis center of the First Affiliated Hospital of
Soochow University were analyzed，and overnight peritoneal effluents and peripheral blood were collected. The patients were grouped
into H/HA or L/LA group according to the peritoneal equilibration test（PET）results，and the clinical data of the patients were
collected. All the patients were followed up for 17 months，and adverse events were recorded. ELISA assays were used to assess IL⁃
36α，IL⁃36β，and IL⁃36γ levels in peritoneal effluents and serum. The predictive role of effluent IL⁃36 was determined by Pearson
correlation and logistic regression analysis. Results：The IL ⁃ 36α AR and IL ⁃ 36γ AR levels in overnight drained dialysate were
significantly correlated with D/P Cr（r=0.51，P＜0.001；r=0.55，P＜0.001）and D/D0 glucose（r=- 0.40，P＜0.001；r=- 0.44，P＜
0.001）. Logistical regression analysis showed that the effluent IL ⁃ 36α AR or IL ⁃ 36γ AR level in peritoneal effluents was an
independent predictive factor for the peritoneal solute transport rate（OR=1.40，P=0.001；OR=1.08，P=0.016）. The area under the
receiver operating characteristic（ROC）curve of effluent IL⁃36α AR was 0.75（95%CI：0.66⁃0.84，P < 0.001）；IL⁃36γ AR was 0.79

［基金项目］ 国家自然科学基金（81700589）
∗
通信作者（Corresponding author），E⁃mail：sdfyylgy@163.com