CAJ | 학술논문

目的探讨血液透析患者脂代谢紊乱的临床特征及低密度脂蛋白受体相关蛋白(LRP)外显子3RsaⅠ位点基因多态性对脂代谢的影响.方法生化方法检测血液透析患者血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDLC)、低密度脂蛋白胆固醇(LDLC)、载脂蛋白(Apo)A1、ApoB、ApoE及脂蛋白(Lp)(a)水平,多聚合酶链反应-限制性片断长度多态性方法( PCR - RFLP)检测LRP外显子3Rsa Ⅰ位点基因多态性.健康体检者372例作为对照组.结果血液透析患者脂代谢紊乱主要表现为血清TG水平显著增高,HDLC水平显著降低.血清TG水平高于正常者为33％,HDLC低于正常者为10.4％.偏相关回归分析显示,TG水平与血清ALB水平、透析时体外循环血流量显著相关；HDLC与KT/V显著相关.血液透析患者高血压的发生率为73.6％,心血管疾病为25％.伴心血管疾病组TG水平显著高于无心血管疾病组,伴高血压组与无高血压组血脂水平无显著差异.LRP基因多态性分析显示,LRP外显子3基因型C/C与等位基因C发生频率较高,病例组与对照组间无显著差异.对照组基因型C/T者血清TC、TG、LDLC水平高于基因型为C/C者,后者具有显著性差异；病例组无显著差异病例组外显子3 Rsa Ⅰ位点不同基因型间血脂水平无显著差异.结论血液透析患者脂代谢紊乱主要表现为血清TG、ApoB水平显著增高,HDLC等指标显著降低.伴心血管并发症的患者TG水平显著高于无并发症的患者.TG水平与血清ALB水平、透析时体外循环血流量显著相关；HDLC与KT/V显著相关.LRP外显子3 Rsa Ⅰ位点基因多态性对正常人群与血液透析患者血脂水平有不同的影响.
목적 탐토혈액투석환자지대사문란적림상특정급저밀도지단백수체상관단백(LRP)외현자3RsaⅠ위점기인다태성대지대사적영향.방법 생화방법검측혈액투석환자혈청총담고순(TC)、감유삼지(TG)、고밀도지단백담고순(HDLC)、저밀도지단백담고순(LDLC)、재지단백(Apo)A1、ApoB、ApoE급지단백(Lp)(a)수평,다취합매련반응-한제성편단장도다태성방법( PCR - RFLP)검측LRP외현자3Rsa Ⅰ위점기인다태성.건강체검자372례작위대조조.결과 혈액투석환자지대사문란주요표현위혈청TG수평현저증고,HDLC수평현저강저.혈청TG수평고우정상자위33％,HDLC저우정상자위10.4％.편상관회귀분석현시,TG수평여혈청ALB수평、투석시체외순배혈류량현저상관；HDLC여KT/V현저상관.혈액투석환자고혈압적발생솔위73.6％,심혈관질병위25％.반심혈관질병조TG수평현저고우무심혈관질병조,반고혈압조여무고혈압조혈지수평무현저차이.LRP기인다태성분석현시,LRP외현자3기인형C/C여등위기인C발생빈솔교고,병례조여대조조간무현저차이.대조조기인형C/T자혈청TC、TG、LDLC수평고우기인형위C/C자,후자구유현저성차이；병례조무현저차이병례조외현자3 Rsa Ⅰ위점불동기인형간혈지수평무현저차이.결론 혈액투석환자지대사문란주요표현위혈청TG、ApoB수평현저증고,HDLC등지표현저강저.반심혈관병발증적환자TG수평현저고우무병발증적환자.TG수평여혈청ALB수평、투석시체외순배혈류량현저상관；HDLC여KT/V현저상관.LRP외현자3 Rsa Ⅰ위점기인다태성대정상인군여혈액투석환자혈지수평유불동적영향.
Objectives To investigate the characteristics of dislipidemia and influence by low density lipoprotein receptor related protein (LRP) exon 3 Rsa Ⅰ gene polymorphism in hemodialysis patients.Methods serum total cholesterol (TC),triglyceride (TG),low density lipoprotein cholesterol (LDLC),high density lipoprotein cholesterol ( HDLC),apolipoproteins ( Apo A1,B,E) and lipoprotein (a) [Lp (a)] were measured,polymerase chain reaction - restriction fragment length polymophism ( PCR - RFLP) was used to detect LRP gene polymorphism in hemodialysis patients.Results The serum levels of TG and ApoB were higher significantly in the hemodialysis patients compared to contrals,and the levels of TC,LDLC,HDLC were lower compared to controls.Patients with cardiovascular disorder had higher TG level compared to patients without the disorder.The data of LRP polymorphism detected by PCR - RFLP showed that the allele frequency and the distribution of the LRP genotype of tetranucleotide reapeat sequence and exon 3 did not differ significantly between controls and hemodialysis patients.There was no statistic difference in serum lipid level between hemodialysis patients with different genotype of LRP exon 3.Conclusions Hemodialysis patients were liable to develop hypertrglyeridemia and hypocholesteroldemia.TG level might related to the development of cardiovascular disorder in hemodialysis patients.There is different influence of LRP Rsa Ⅰ gene polymorphism on lipid levels between controls and hemodialysis patients.