中南大学学报（医学版）
中南大學學報（醫學版）
중남대학학보（의학판）
JOURNAL OF CENTRAL SOUTH UNIVERSITY (MEDICAL SCIENCES)
2009年
4期
289-294
,共6页
张卫茹%周成%谢晋良%陈本美%昌兰
張衛茹%週成%謝晉良%陳本美%昌蘭
장위여%주성%사진량%진본미%창란
肾移植术%非对称二甲基精氨酸%内皮功能不全%氧化应激
腎移植術%非對稱二甲基精氨痠%內皮功能不全%氧化應激
신이식술%비대칭이갑기정안산%내피공능불전%양화응격
kidney transplantation%asymmetric dimetylarginine%endothelial dysfunction%oxidative stress
目的:探讨肾移植前后慢性肾衰患者血清非对称二甲基精氨酸(ADMA)水平变化与内皮功能改善的关系.方法:选择首次接受同种异体肾移植术患者38例和健康对照者36例.分别于移植术前、移植术后第1,3,7,14及28天抽血分离血清,高效液相色谱法(HPLC)检测血清ADMA和SDMA水平,硝酸还原酶比色法检测血清NO活性,DTNB法测定全血硒谷胱甘肽过氧化物酶 (SeGSHPx)活性,,硫代巴比妥酸法测定血清丙二醛(MDA)水平,ELISA法检测血清C反应蛋白(CRP)水平;移植术前及术后第28天多普勒超声法检测肱动脉内皮依赖性血管舒张功能(FMD).结果:肾移植术前患者血清ADMA[(2.36±0.89) μmol/L],SDMA[(0.48±0.11) μmol/L],MDA[(7.24±1.07) μmol/L]及CRP水平[9.24(0.42～66.24) μmol/L]明显高于年龄匹配的正常对照组[ADMA:(0.49±0.12) μmol/L;SDMA:(0.24±0.08) μmol/L;MDA:(3.12±1.21) μmol/L;CRP:2.52(0.24～5.94) μmol/L, 均P＜0.01],血清NO[(38.48±12.36) μmol/L] 及SeGSHPx[(104.23±14.46) U/L]活性、FMD(5.43%±1.87%)明显低于正常对照组 [NO:(70.13±12.46) μmol/L;SeGSHPx:(201.36±82.35) U/L;FMD:(10.11±1.64)%,均P＜0.01].移植术后第1天开始血清ADMA[(1.97±0.76) μmol/L],SDMA[(0.43±0.06) μmol/L],MDA[(6.24±0.82) μmol/L]及CRP[8.32(0.46～33.42) μmol/L]水平明显下降而血清NO[(42.63±11.32) μmol/L],SeGSHPx[(116.23±17.24) U/L]活性明显增高,第28天时除SDMA水平与对照组无差别外(P＞0.05),其余指标仍高于或低于正常对照组(P＜0.05).第28天时FMD(7.04±2.13)%较移植前明显增高但仍低于正常时对照组(P＜0.05).移植前后血清ADMA水平与MDA呈正相关,与SeGSHPx及FMD呈负相关.结论:慢性肾衰患者移植前后血清ADMA水平变化与内皮功能异常关系密切,并与氧化应激程度相关.
目的:探討腎移植前後慢性腎衰患者血清非對稱二甲基精氨痠(ADMA)水平變化與內皮功能改善的關繫.方法:選擇首次接受同種異體腎移植術患者38例和健康對照者36例.分彆于移植術前、移植術後第1,3,7,14及28天抽血分離血清,高效液相色譜法(HPLC)檢測血清ADMA和SDMA水平,硝痠還原酶比色法檢測血清NO活性,DTNB法測定全血硒穀胱甘肽過氧化物酶 (SeGSHPx)活性,,硫代巴比妥痠法測定血清丙二醛(MDA)水平,ELISA法檢測血清C反應蛋白(CRP)水平;移植術前及術後第28天多普勒超聲法檢測肱動脈內皮依賴性血管舒張功能(FMD).結果:腎移植術前患者血清ADMA[(2.36±0.89) μmol/L],SDMA[(0.48±0.11) μmol/L],MDA[(7.24±1.07) μmol/L]及CRP水平[9.24(0.42～66.24) μmol/L]明顯高于年齡匹配的正常對照組[ADMA:(0.49±0.12) μmol/L;SDMA:(0.24±0.08) μmol/L;MDA:(3.12±1.21) μmol/L;CRP:2.52(0.24～5.94) μmol/L, 均P＜0.01],血清NO[(38.48±12.36) μmol/L] 及SeGSHPx[(104.23±14.46) U/L]活性、FMD(5.43%±1.87%)明顯低于正常對照組 [NO:(70.13±12.46) μmol/L;SeGSHPx:(201.36±82.35) U/L;FMD:(10.11±1.64)%,均P＜0.01].移植術後第1天開始血清ADMA[(1.97±0.76) μmol/L],SDMA[(0.43±0.06) μmol/L],MDA[(6.24±0.82) μmol/L]及CRP[8.32(0.46～33.42) μmol/L]水平明顯下降而血清NO[(42.63±11.32) μmol/L],SeGSHPx[(116.23±17.24) U/L]活性明顯增高,第28天時除SDMA水平與對照組無差彆外(P＞0.05),其餘指標仍高于或低于正常對照組(P＜0.05).第28天時FMD(7.04±2.13)%較移植前明顯增高但仍低于正常時對照組(P＜0.05).移植前後血清ADMA水平與MDA呈正相關,與SeGSHPx及FMD呈負相關.結論:慢性腎衰患者移植前後血清ADMA水平變化與內皮功能異常關繫密切,併與氧化應激程度相關.
목적:탐토신이식전후만성신쇠환자혈청비대칭이갑기정안산(ADMA)수평변화여내피공능개선적관계.방법:선택수차접수동충이체신이식술환자38례화건강대조자36례.분별우이식술전、이식술후제1,3,7,14급28천추혈분리혈청,고효액상색보법(HPLC)검측혈청ADMA화SDMA수평,초산환원매비색법검측혈청NO활성,DTNB법측정전혈서곡광감태과양화물매 (SeGSHPx)활성,,류대파비타산법측정혈청병이철(MDA)수평,ELISA법검측혈청C반응단백(CRP)수평;이식술전급술후제28천다보륵초성법검측굉동맥내피의뢰성혈관서장공능(FMD).결과:신이식술전환자혈청ADMA[(2.36±0.89) μmol/L],SDMA[(0.48±0.11) μmol/L],MDA[(7.24±1.07) μmol/L]급CRP수평[9.24(0.42～66.24) μmol/L]명현고우년령필배적정상대조조[ADMA:(0.49±0.12) μmol/L;SDMA:(0.24±0.08) μmol/L;MDA:(3.12±1.21) μmol/L;CRP:2.52(0.24～5.94) μmol/L, 균P＜0.01],혈청NO[(38.48±12.36) μmol/L] 급SeGSHPx[(104.23±14.46) U/L]활성、FMD(5.43%±1.87%)명현저우정상대조조 [NO:(70.13±12.46) μmol/L;SeGSHPx:(201.36±82.35) U/L;FMD:(10.11±1.64)%,균P＜0.01].이식술후제1천개시혈청ADMA[(1.97±0.76) μmol/L],SDMA[(0.43±0.06) μmol/L],MDA[(6.24±0.82) μmol/L]급CRP[8.32(0.46～33.42) μmol/L]수평명현하강이혈청NO[(42.63±11.32) μmol/L],SeGSHPx[(116.23±17.24) U/L]활성명현증고,제28천시제SDMA수평여대조조무차별외(P＞0.05),기여지표잉고우혹저우정상대조조(P＜0.05).제28천시FMD(7.04±2.13)%교이식전명현증고단잉저우정상시대조조(P＜0.05).이식전후혈청ADMA수평여MDA정정상관,여SeGSHPx급FMD정부상관.결론:만성신쇠환자이식전후혈청ADMA수평변화여내피공능이상관계밀절,병여양화응격정도상관.
Objective To investigate the relation between serum asymmetric dimethylarginine (ADMA) level and endothelial function before and after living donor kidney transplantation in uremic patients.Methods A total of 38 renal transplant patients (21males and 17 females) and 36 healthy controls (20 males and 16 females) were enrolled. Plasma ADMA, symmetric dimethylarginine (SDMA), malondialdehyde (MDA), glutathione peroxidase (SeGSHPx), C-reactive protein (CRP) were mea-sured before transplantation and on Days 1, 3, 7, 14, and 28 posttransplantation. The brachial artery flow mediated dilatation (FMD) was studied before transplantation and on the 28th day after the transplantation. Results Serum levels of ADMA,SDMA,MDA and CRP were significantly increased, and the activities of nitric oxide (NO) and SeGSHPx were decreased in uremic patients compared with age matched healthy subjects (all P＜0.01). Serum levels of ADMA,SDMA,MDA and CRP decreased while the activities of NO and SeGSHPx increased significantly at the first day after the transplantation (all P＜0.01). The decrement of plasma SDMA normalized on the 28th day (P＞0.05). The FMD was lower in the patients than the control group (P＜0.01) and improved significantly on the 28th day of posttransplantation (P＜0.05). Serum levels of ADMA were positively correlated with MDA (r=0.412, P＜0.01;r=0.342,P＜0.01) and negatively correlated with the values of SeGSHPx (r=-0.345, P＜0.01;r=-0.315, P＜0.01) and FMD (r=-0.452,P＜0.01;r=-0.416,P＜0.01) both before and after kidney transplantation. Conclusion The level of serum ADMA is associated with endothelial function improvement in uremic patients both before and after kidney transplantation.
