CAJ | 학술논문

目的探讨中介素在慢性肾脏病时的水平变化及其与同型半胱氨酸、胱抑素C的相关性.方法检测30名健康人和147例慢性肾脏病患者血浆中介素、肾上腺髓质素和转化生长因子β1的浓度,根据肾小球滤过率将患者分为1～5期,分析三者在不同分期的变化及其与同型半胱氨酸、胱抑素C的关系.结果慢性肾脏病分期不同者β2微球蛋白、胱抑素C、同型半胱氨酸、肾小球滤过率、肾上腺髓质素、转化生长因子β1水平与对照组相比差异有统计学意义(均P＜ 0.05),中介素含量差异亦无统计学意义(P＞0.05).在肾小球滤过率＞60 ml/min的慢性肾脏病患者中,肾病综合征亚组和IgA肾病亚组血浆中介素含量明显高于对照组,差异有统计学意义(P＜0.05);各亚组肾上腺髓质素含量与对照组相比差异无统计学意义(P=0.086);各亚组转化生长因子β1含量均明显高于对照组(P＜0.05).在肾小球滤过率＞60 ml/min的慢性肾脏病患者中,IgA肾病亚组中介素与胱抑素C、同型半胱氨酸呈显著正相关(R1=R2=0.9,P1=P2=0.037).结论血浆中介素、肾上腺髓质素和转化生长因子β1慢性肾脏病进展中呈现一定的变化趋势(尤其在IgA肾病早期变化明显),且与血管损伤因子同型半胱氨酸、胱抑素C呈正相关,提示中介素和肾上腺髓质素可能参与慢性肾脏病血管损伤的病理过程,而转化生长因子β1在肾纤维化过程中的变化反映了机体自我调节的作用.
목적 탐토중개소재만성신장병시적수평변화급기여동형반광안산、광억소C적상관성.방법 검측30명건강인화147례만성신장병환자혈장중개소、신상선수질소화전화생장인자β1적농도,근거신소구려과솔장환자분위1～5기,분석삼자재불동분기적변화급기여동형반광안산、광억소C적관계.결과 만성신장병분기불동자β2미구단백、광억소C、동형반광안산、신소구려과솔、신상선수질소、전화생장인자β1수평여대조조상비차이유통계학의의(균P＜ 0.05),중개소함량차이역무통계학의의(P＞0.05).재신소구려과솔＞60 ml/min적만성신장병환자중,신병종합정아조화IgA신병아조혈장중개소함량명현고우대조조,차이유통계학의의(P＜0.05);각아조신상선수질소함량여대조조상비차이무통계학의의(P=0.086);각아조전화생장인자β1함량균명현고우대조조(P＜0.05).재신소구려과솔＞60 ml/min적만성신장병환자중,IgA신병아조중개소여광억소C、동형반광안산정현저정상관(R1=R2=0.9,P1=P2=0.037).결론 혈장중개소、신상선수질소화전화생장인자β1만성신장병진전중정현일정적변화추세(우기재IgA신병조기변화명현),차여혈관손상인자동형반광안산、광억소C정정상관,제시중개소화신상선수질소가능삼여만성신장병혈관손상적병리과정,이전화생장인자β1재신섬유화과정중적변화반영료궤체자아조절적작용.
Objective To investigate plasma level of intermedin (IMD) in patients with chronic kidney disease (CKD) and its relatiomhip with homocysteine (Hcy) and cystatin-C (Cyc-C).Methods Thirty health subjects and 147 CKD patients were detected for plasma IMD,ADM and TGF-β1.Results The patients with the different stages of CKD had significantly different levels of β2 microglobulin,Cyc-C,Hcy,GFR,ADM,and TGF-β1 levels from the controls (all P ＜ 0.05).For CKD subjects with GFR ＞ 60ml/min,the plasma IMD level was significantly increased in nephrotic syndrome and IgA nephropathy subgroups (P ＜ 0.05) ; ADM in each subgroup showed no statistically significant difference from the healthy controls (P =0.086) ; TGF-β1 levels in each subgroup were significantly increased (P ＜ 0.05).For IgA nephropathy patients with GFR ＞ 60 ml/min,IMD showed a significantly positive correlation with Cys-C and Hcy (R1 =R2 =0.9,P1 =P2 =0.037).Conclusion Plasma IMD,ADM and TGF-β1 showed certain changing trend in the progression of CKD,especially in IgA nephropathy.IMD and ADM may be involved in the pathological process of vascular injury in CKD,while TGF-β1's contribution to renal fibrosis reflects the role of self-regulation.