STUDY ON DETERIORATING MECHANISM OF PERITONEAL FUNCTIONUSING CULTURED MESOTHELIAL CELL

随着腹膜透析时间的延长，硬化性包裹性腹膜炎（SEP）的发生率增加。假设在高浓度葡萄糖下可能发生胶原基质的水化变性，这可能导致间皮细胞生长减少。为了了解高渗透状态下间皮细胞的再生机制和化学诱导腹膜炎时腹膜渗透性的变化，用培养的间皮细胞进行体外实验和用腹膜内注射葡萄糖酸氯己定（CHG）进行体内实验。在I型胶原包被的多滴定板暴露1至5周后。对于不同浓度的葡萄糖，无论补充的葡萄糖浓度是多少，接种的间皮细胞的生长在2g/dl的白蛋白补充物下都受到抑制。在没有高浓度白蛋白的情况下，DNA合成呈葡萄糖剂量依赖性。用10%FCS/MEM培养的大鼠间皮细胞，经葡萄糖浸泡1周后，DNA合成量与对照组无显著性差异。将0.08- 0.2wt%CHG 20 ml/kg注入雄性Wistar大鼠腹腔（8周）。11只大鼠中有8只存活，8只大鼠中有5只发生粘连，1只发生SEP样变性。MTAC从1.18（±）SY. [）0.66ml/min至1.92（]SY. []前3周为0.6ml/min（p=0.09），第4周略有下降。

Incidence of sclerosing encapsulating peritonitis (SEP) increases as a duration of peritoneal dialysis is prolonged. It has been hypothesized that hydrated degeneration of collagen matrix is possibly occurred at high concentration of glucose and it may result in reducing cell growth in the mesothelium.To understand both mechanism of regeneration of the mesothelial cell under high permeable state and change in peritoneal permeability under chemically induced peritonitis, in vitro experiments with cultured mesothelial cells and in vivo experiments with intraperitoneal injection of Chlorohexidine gluconate (CHG) were carried out. After one to five week exposure of type I collagen coated multi-titer plate. to varying concentrations of glucose, growth of mesothelial cells seeded were suppressed at 2g/dl of albumin supplement no matter what concentration of glucose supplemented was. Without high concentration of albumin, DNA synthesis was in a dose-dependent manner of glucose. There was no significant difference of DNA synthesis between groups with and without one-week glucose immerse when mesothelial cells were cultured only 10%FCS/MEM.20ml/kg of 0.08-0.2wt% CHG was injected into the abdominal space of male Wistar rat (at 8 weeks). Eight out of 11 rats were survived and 5 out of 8 rats developed adhesions and one developed SEP-like degeneration. Although there was no statistically signifficant change, MTAC increased from 1.18(]SY.+-。[)0.66ml/min to 1.92(]SY.+-。[)0.6ml/min in the first three weeks (p=0.09) and slightly decreased at the 4th week.