中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2014年
1期
31-34
,共4页
殷俊%黄娟%袁伟杰%谷立杰%王玲%尚明花
慇俊%黃娟%袁偉傑%穀立傑%王玲%尚明花
은준%황연%원위걸%곡립걸%왕령%상명화
肾功能不全,慢性%腹直肌%肌萎缩%Foxo1%泛素溶酶体系统
腎功能不全,慢性%腹直肌%肌萎縮%Foxo1%汎素溶酶體繫統
신공능불전,만성%복직기%기위축%Foxo1%범소용매체계통
Renal insufficiency,chronic%Rectus abdominis%Muscle atrophy%Foxo1%Ubiquitin-proteasome system
目的 观察终末期肾病患者骨骼肌萎缩表现,并初步探讨腹直肌中转录因子Foxo1及泛素溶酶体系统活性变化与骨骼肌萎缩的关系.方法 对慢性肾脏病(CKD)5期的22例尿毒症患者在腹膜透析置管术中行腹直肌活检.并将8例诊断为子宫腺肌病并拟行经腹全子宫切除术患者及6例确诊为腹壁疝并拟行腹壁疝修补术患者设为对照组,于手术时留取少许腹直肌标本.观察肌纤维形态、计算肌纤维横截面积,并检测Foxo1及泛素溶酶体系统标志物Atrogin-1及MuRF1的mRNA和蛋白的表达情况.结果 CKD组患者腹直肌肌纤维的横截面面积较对照组明显缩小(P＜0.01),CKD组Foxo1、Atrogin-1及MuRF1的mRNA含量及蛋白表达量均较对照组明显增加(P＜0.05),而p-Foxo1蛋白表达量较对照组降低(P＜0.05).结论 CKD患者存在肌萎缩现象,推测其与Foxo1表达上调、磷酸化程度降低以及泛素溶酶体系统活性亢进有关.
目的 觀察終末期腎病患者骨骼肌萎縮錶現,併初步探討腹直肌中轉錄因子Foxo1及汎素溶酶體繫統活性變化與骨骼肌萎縮的關繫.方法 對慢性腎髒病(CKD)5期的22例尿毒癥患者在腹膜透析置管術中行腹直肌活檢.併將8例診斷為子宮腺肌病併擬行經腹全子宮切除術患者及6例確診為腹壁疝併擬行腹壁疝脩補術患者設為對照組,于手術時留取少許腹直肌標本.觀察肌纖維形態、計算肌纖維橫截麵積,併檢測Foxo1及汎素溶酶體繫統標誌物Atrogin-1及MuRF1的mRNA和蛋白的錶達情況.結果 CKD組患者腹直肌肌纖維的橫截麵麵積較對照組明顯縮小(P＜0.01),CKD組Foxo1、Atrogin-1及MuRF1的mRNA含量及蛋白錶達量均較對照組明顯增加(P＜0.05),而p-Foxo1蛋白錶達量較對照組降低(P＜0.05).結論 CKD患者存在肌萎縮現象,推測其與Foxo1錶達上調、燐痠化程度降低以及汎素溶酶體繫統活性亢進有關.
목적 관찰종말기신병환자골격기위축표현,병초보탐토복직기중전록인자Foxo1급범소용매체계통활성변화여골격기위축적관계.방법 대만성신장병(CKD)5기적22례뇨독증환자재복막투석치관술중행복직기활검.병장8례진단위자궁선기병병의행경복전자궁절제술환자급6례학진위복벽산병의행복벽산수보술환자설위대조조,우수술시류취소허복직기표본.관찰기섬유형태、계산기섬유횡절면적,병검측Foxo1급범소용매체계통표지물Atrogin-1급MuRF1적mRNA화단백적표체정황.결과 CKD조환자복직기기섬유적횡절면면적교대조조명현축소(P＜0.01),CKD조Foxo1、Atrogin-1급MuRF1적mRNA함량급단백표체량균교대조조명현증가(P＜0.05),이p-Foxo1단백표체량교대조조강저(P＜0.05).결론 CKD환자존재기위축현상,추측기여Foxo1표체상조、린산화정도강저이급범소용매체계통활성항진유관.
Objective To identity whether there is muscle atrophy phenomenon in end-stage kidney disease patients and to detect the level of transcription factor Foxo1 and the activity of ubiquitin-proteasome system.Methods Twenty-two patients in chronic kidney disease (CKD) stage 5 were selected and their mean muscle cross sectional area was measured.mRNA and protein levels of Foxo1,Atrogin-1,MuRF1 in rectus abdominis biopsies obtained from consecutive patients were detected.Control biopsies were obtained from 8 healthy subjects during elective surgery for abdominal wall hernias and 6 subjects during elective surgery for adenomyosis.Results Compared with the control group,cross sectional area of muscle fibers decreased and the transcription and protein levels of Foxo1,Atrogin-1,MuRF1 were upregulated in CKD group(P＜0.05).Protein level of p-Foxo1 decreased in CKD group(P＜0.05).Conclusion There exist muscle atrophy phenomenon in CKD patients,which may associate with the upregulation of Foxo1 and activation of ubiquitin-proteasome system.
