CAJ | 학술논문

目的探讨尿毒症患者血清不对称性二甲基精氨酸(ADMA)与动脉内皮损伤的相关性.方法选择新诊断未透析的尿毒症患者40例(A组)和已行血液透析的尿毒症患者45例(B组),并选取正常健康人20例为健康对照组(C组)及20例慢性肾脏病2～4期患者(D组).应用多普勒超声检测左前臂桡动脉内、中膜厚度和内皮舒张功能.检测各组血清ADMA及各项生化指标水平.结果与C组比较,A组、B组及D组患者血清ADMA的水平均显著升高[(0.78±0.19) μmol/Lvs (1.51 ±0.16) μmol/L、(1.13 ±0.14)tμmol/L、(0.92±0.11) μmol/L,P＜0.05].与A组比较,B组血清ADMA、CRP[(8.4±1.35) mg/L vs (6.5 ±0.8) mg/L,P＜0.05]显著降低.与C组比较,A组、B组及D组患者桡动脉内皮依赖性舒张功能[(13.52±1.73)％ vs (7.32±0.54)％、(9.02±0.86)％、(10.13±1.25)％,P＜ 0.05]和非依赖性舒张功能[(14.45± 1.85)％ vs (10.37±1.51)％、(9.54±1.39)％、(11.17±1.56)％,P ＜0.05]均显著下降.B组内皮依赖性舒张功能较A组增加(P＜0.05).A组血清ADMA含量与内皮依赖性舒张功能呈负相关(r=-0.81,P=0.020).结论尿毒症患者血清ADMA的显著升高,其升高与动脉内皮功能损伤密切相关.
목적 탐토뇨독증환자혈청불대칭성이갑기정안산(ADMA)여동맥내피손상적상관성.방법 선택신진단미투석적뇨독증환자40례(A조)화이행혈액투석적뇨독증환자45례(B조),병선취정상건강인20례위건강대조조(C조)급20례만성신장병2～4기환자(D조).응용다보륵초성검측좌전비뇨동맥내、중막후도화내피서장공능.검측각조혈청ADMA급각항생화지표수평.결과 여C조비교,A조、B조급D조환자혈청ADMA적수평균현저승고[(0.78±0.19) μmol/Lvs (1.51 ±0.16) μmol/L、(1.13 ±0.14)tμmol/L、(0.92±0.11) μmol/L,P＜0.05].여A조비교,B조혈청ADMA、CRP[(8.4±1.35) mg/L vs (6.5 ±0.8) mg/L,P＜0.05]현저강저.여C조비교,A조、B조급D조환자뇨동맥내피의뢰성서장공능[(13.52±1.73)％ vs (7.32±0.54)％、(9.02±0.86)％、(10.13±1.25)％,P＜ 0.05]화비의뢰성서장공능[(14.45± 1.85)％ vs (10.37±1.51)％、(9.54±1.39)％、(11.17±1.56)％,P ＜0.05]균현저하강.B조내피의뢰성서장공능교A조증가(P＜0.05).A조혈청ADMA함량여내피의뢰성서장공능정부상관(r=-0.81,P=0.020).결론 뇨독증환자혈청ADMA적현저승고,기승고여동맥내피공능손상밀절상관.
Objective To investigate the correlation between asymmetric dimethylarginine (AD-MA) and endothelial dysfunction in patients with uremia.Methods Uremic patients who did not receive hemodialysis were defined as A group (n =40) ; uremic patients who had received hemodialysis were divided into B group (n =45) ;healthy people were defined as C group (n =20) ;and chronic kidney disease (stage 2 ～ 4) patients were defined as D group (n =20).The diameter of intima-media thickness,and endothelium-dependent or independent dilation (EDD or EID) of radial artery in right forearm were detected with diasonography.The levels of ADMA were determined by high-performance liquid chromatography.Results Compared to C group,the levels of ADMA in A,B and D groups were significantly increased [C:(0.78 ±0.19) μmol/L,A:(1.51 ±0.16) μ mol/L,B:(1.13 ±0.14) μmol/L,D:(0.92 ±0.11) μmol/L; P ＜0.05].Compared to A group,the levels of ADMA were significantly decreased in B group (P ＜0.05).EDD and EID were decreased significantly in A,B and D groups compared to C group [EDD:C:(13.52±1.73)％ vs A:(7.32 ±0.54)％,B:(9.02 ±0.86)％,D:(10.13 ±1.25)％,P ＜0.05;EID:C:(14.45±1.85)％ vsA:(10.37 ±1.51)％,B:(9.54±1.39)％,D:(11.17±1.56)％,P ＜0.05].EDD in B group was significantly lower than A group (P ＜0.05).In group A,a negative correlation was found between EDD and the level of ADMA (r =-0.81,P =0.020).Conclusions ADMA level was significantly increased in uremic patients.A close correlation existed between ADMA and endothelial dysfunction of radial artery.