The Study Of Different Hemodialysis Way And Dialysis Membrane To Endothelial Cell And Intervention Measure Of Medication

Objective:To investigate the effect of different hemodialysis way and dialysis-membrane on HUVEC vigor,the expression of ICAM-1,the nitrogen monoxide(NO),malonyldialdehyde(MDA),superoxide dismutase(SOD),as well as intervention of GSH in the patients with maintenance hemodialysis.The aim is inquiring into the possible mechanisms about endothelium impair and provide the theory for preventing and treating cardiovascular disease in maintenance hemodialysis Patient.Methods:Collecting serum from maintenance hemodialysis patients(30cases) as experiment group and healthy people(15cases) as normal control group,coming from Blood Purification Center of Jinan Central Hospital,Shandong University.Divided into six groups according to different dialysis way and dialysis membrane,HUVEC are incubation 3 hours,6 hours and 12 hours with 10%different dialysis way and dialysis membrane serum.The experiment was divided into the blank control group (pure nutrient fluid raise group 10%FCS),the experimental group(acetate fiber membrane(CA) the hemodialysis(HD) group,polysulphone membrane(PS) the HD group,hemodialysis has filtered the(HDF) group,the HD+CA+GSH group,the HD+PS+GSH group,the HDF+GSH group) around the dialysis the blood serum.Observes the change in each group of HUVEC in3 hours,6 hours and 12 hours,the MTT determined the vigor of HUVEC in each group,Flows cell meter(FCM) was used to determine expression of ICAM-1 in each group of HUVEC in 3 hour,6 hour and 12 hours,the ELISA was used to determine the change of NO,MDA,SOD in each group of HUVEC raise supemate 3 hours separately,6 hours and 12 hours.Results:1.The influence to cell vigorDifferent dialysis way and dialysis membranes,the patient blood serum stimulated the HUVEC 18 hour separately,24 hours later,the cell growth appeared suppresses,and was more obvious along with the time extension inhibitory action;The A group grow to the cell suppresses obviously.Each group of patient blood serum and HUVEC altogether foster for 12 hours,did not have the influence to the cell growth and the reproduction(to compare P＞0.05 with control group);Altogether fostered with HUVEC for 18 hours and 24 hours,the A group and the control group comparison difference had the significance(P＜0.05).The CA group and the CA+GSH group,the PS+GSH group comparison difference had the significance(P＜0.05).Therefore we choose the blood serum in the following experiment to stimulate the HUVEC6 hour and 12 hours,guaranteed that the blood serum did not have the influence to the cell growth multiplication.2.The ICAM-1 influence of different dialysis membrane and dialysis way dialysis to endothelial cellEach group of blood serums and endothelial cell combined action 6 hours later,before the dialysis,ICAM-1 expresses the experimental group and the control group comparison difference had statistics significance(P＜0.05),between various experimental groups,the comparison difference did not have the significance;After the dialysis,the A group and the B group compare the ICAM-1 expression difference to have statistics significance(P＜0.05),the identical kind of dialysis membrane B group and C group compare ICAM-1 the expression difference to have the remarkable statistics significance(P＜0.01),after the dialysis applies the return to original state Guguangantai(GSH),each group of ICAM-1 expression obviously had not reduced with the GSH group,the difference had statistics significance(P＜0.05);The comparison difference had no significance with GSH group each group of dialysis around.Affected 12 hours later,each group of ICAM-1 expression and 6 hour comparison difference statistics significance.Affected around 24 hour each group of dialysis to compare ICAM-1 the expression difference non-statistics significance.3.HUVEC raise supernate NO,MDA,SOD test resultEach group of blood serums and the endothelial cell combined action 6 hours,before the dialysis,the experimental group and the control group compare NO,SOD to reduce MDA to elevate had statistics significance(P＜0.05),between various experimental groups comparison difference not remarkable statistics significance; After the dialysis,the A group and the B group,the B group and Cgroup compare NO, SOD to reduce MDA to elevate had statistics significance(P＜0.05),around each group of dialysis the comparison,with the GSH group dialysis around the difference non-statistics significance,after applying the GSH group dialysis,NO,SOD had not had elevates,MDA reduces,the difference had statistics significance(P＜0.05)。Affected 12 hours later,before the dialysis,the experimental group and the control group compare NO,SOD to reduce MDA to elevate have the remarkable statistics significance(P＜0.01),after the dialysis,the A group and the B group,the Bgroup and the C group compare NO,SOD to reduce MDA to elevate have the remarkable statistics significance(P＜0.01),After GSH group dialysis NO,SOD hade levated, MDA reduced,the difference had statistics significance(P＜0.01).Before 24 hour dialysis,tests each group and the control group compared the NO,MDA,SOD difference non-statistics significance,before after the D,E,F group dialysis, compares the dialysis,NO to increase,the difference had statistics significance,D group increased obviously;After D,E,F group each group of dialysis,before comparing the dialysis,MDA to reduce the difference to have the remarkable statistics significance;After D,E,F group dialysis,before comparing the dialysis, SOD to elevate,the difference has statistics significance.Conclusion:(1) There are high rates of cardiovascular disease formation rate in end-stage renal disease patients requiring maintenance dialysis compared to the normal,Atherosclerosis(AS) is the foundation which cardiovascular disease occurs, endothelial cell function barrier oneself by the proof is as most early time change。The identical dialysis way different dialysis membrane comparison,the polysulphone membrane compares the acetate fiber membrane to vitro raise endothelial cell's damage to be light,the identical dialysis membrane different dialysis way comparison, the hemodialysis filters has been light to endothelial cell's damage.(2) In the dialysis process applies the return to original state Guguangantai(GSH), has certain protective function to the damage endothelial cell,and along with the time extension,this kind of protective function is more obvious.(3) The endothelial cell damage's factor are many,besides traditional factors and so on hypertension,volume load and uremia toxin,in the dialysis process oxidizes the stress also easily to cause the bast damage,this is possibly an alternative factor which the dialysis patient cardiovascular occurs.(4) Further studying is important to differently for medicine time and medicament quantity to be whether more advantageous in reduces the endothelial cell damage.