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題名 | Comparison of the Plasma Carnitine between End Stage Renal Disease Patients on Hemodialysis and Continuous Ambulatory Peritoneal Dialysis=血液透析及腹膜透析之末期腎病病人血漿肉質素之比較 |
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作者姓名(中文) | 張玉梅; 吳志仁; 陳逸洲; 陳漢湘; 葉瑞圻; 莊志光; 林炫沛; | 書刊名 | 臺灣腎臟醫學會雜誌 |
卷期 | 15:1 2001.03[民90.03] |
頁次 | 頁14-19+36 |
分類號 | 415.816 |
關鍵詞 | 肉質素; 末期腎衰竭; 血液透析; 腹膜透析; Carnitine; ESRD; HD; CAPD; |
語文 | 英文(English) |
中文摘要 | 目的:腎臟在肉質素(carnitine)的製造,排除及Acylation方面扮演主要角色,在未期腎病變時,肉質素的代謝變為異常,無論血液透析或腹膜透析之未期腎病病人之血漿肉質都不會下降,但年齡、性別、透析時間配對之血液透析及腹膜透析病人問題總血漿及游離肉質素濃度的差別,並未有人研究過。本研究之目的為比較年齡、性別、透析時間配對之血液透析及腹膜透析病人間總血漿肉質素及游離肉質素的濃度。 配對之26位血液透析及26位腹膜透析病人進行空腹血漿總肉質素之橫斷面研究,對照組為年齡及性別配對之26位健康者。 結果:相對於正常對照組,兩種透析方式病人之總血漿肉質素濃度及游離肉質素濃度都比較低。血液透析病人之透析前游離肉質素濃度有意義的低於腹膜透析病人(28.0±7.7 v.s. 35.5±9.5 umol, P<0.001)。但兩組透析病人間總血漿肉質素濃度並無有意義的差別(43.3±13.0 v.s. 45.2±12.7umol, P=0.65)。血液透析後總血漿肉質素濃度及游離肉質素濃度都有意義的下降。 結論:血液透析病人之血漿游離肉質素濃度比腹膜透析病人低,但結合性肉質素濃度比較高,雖游離及結合性肉質素都可經由血液透析流失,結合性肉質素並未如游離性肉質素容物流失,加上非血液透析時間所堆積的結合性肉質素,導致血液透析病人之結合性容質素濃度比腹膜透析病人高,所以血液透析及腹膜透析病人間總血漿肉質素濃度並無有意義的差別。 |
英文摘要 | Objectives: The kidney plays a major role in carnitine biosynthesis, excretion, and acylation. In end stage renal disease (ESRD), carnitine metabolism is abnormal. It is known that plasma carnitine is decreased in patients with ESRD on either hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD). However, differences between patients on these 2 dialysis modalities in terms of plasma total carnitine (TC) and free carnitine (FC) have not been examine in investigations that control for age, sex, and duration of dialysis. The purpose of this study was to compare TC and FC in patients on HD and CAPD, matching the subjects for age, sex, and duration of dialysis. Methods: A cross-sectional study of plasma TC and FC after an overnight fast was performed on 52 stable dialyzed patients, 26 on HD and 26 on CAPD. These subjects were matched for age, sex, and duration of dialysis. In addition, 26 age-and sex-matched healthy controls were also evaluated. Results: Both TC and FC were lower in patients on either mode of dialysis compared with healthy controls. The FC in patients on HD was significantly lower prior to dialysis than in those on CAPD (28±7.7 vs 35.3±9.5 μmol, p<0.001). However, TC did not significantly differ between HD (before dialysis) and CAPD subjects (43.3±13.0 vs 45.2±12.7 μmol, p=0.65). Both TC and FC decreased significantly after HD. Conclusion: The concentration of plasma FC in patients on HD was significantly lower than in those on CAPD, while that of bound carnitine (BC) was higher. In HD, although both FC and BC are lost through dialysis, the BC was not as easily diffusible as the FC. Added by accumulation of BC during dialysis free interval, results in plasma BC in the patients before HD was higher than in those of CAPD. Therefore, the plasma TC did not differ significantly between the two groups. |
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