CAJ | 학술논문

目的：探讨尿毒症维持性血液透析患者血清不对称性二甲基精氨酸(ADMA)与左室肥厚的相关性。方法选择35例维持性血液透析的尿毒症患者(A组)，应用多普勒超声检测超声心动图及内皮舒张功能，根据有无左室肥厚将A组患者分为左室肥厚组(A1组)及非肥厚组(A2组)。同时选取正常健康人20例为健康对照组，检测各组血清ADMA及各项生化指标水平。结果 A1组和A2组患者的ADMA水平分别为(1.65±0.26)μmol/L和(1.31±0.24)μmol/L，明显高于健康对照组的(0.78±0.19)μmol/L，差异均有统计学意义(P<0.05)；动脉内皮依赖性舒张功能和非依赖性舒张功能均较健康对照组显著下降；与A1组比较，A2组动脉内皮依赖性舒张功能显著升高。相关及回归分析显示，ADMA水平、收缩压、动脉内皮依赖性舒张功能是维持性血液透析患者左室肥厚的独立危险因素。结论尿毒症维持性血液透析患者血清ADMA明显升高，且ADMA升高和左室肥厚密切相关。
목적：탐토뇨독증유지성혈액투석환자혈청불대칭성이갑기정안산(ADMA)여좌실비후적상관성。방법선택35례유지성혈액투석적뇨독증환자(A조)，응용다보륵초성검측초성심동도급내피서장공능，근거유무좌실비후장A조환자분위좌실비후조(A1조)급비비후조(A2조)。동시선취정상건강인20례위건강대조조，검측각조혈청ADMA급각항생화지표수평。결과 A1조화A2조환자적ADMA수평분별위(1.65±0.26)μmol/L화(1.31±0.24)μmol/L，명현고우건강대조조적(0.78±0.19)μmol/L，차이균유통계학의의(P<0.05)；동맥내피의뢰성서장공능화비의뢰성서장공능균교건강대조조현저하강；여A1조비교，A2조동맥내피의뢰성서장공능현저승고。상관급회귀분석현시，ADMA수평、수축압、동맥내피의뢰성서장공능시유지성혈액투석환자좌실비후적독립위험인소。결론뇨독증유지성혈액투석환자혈청ADMA명현승고，차ADMA승고화좌실비후밀절상관。
Objective To investigate the correlation between asymmetric dimethylarginine (ADMA) and left ventricular hypertrophy in patients with maintenance hemodialysis. Methods Thirty-five uremic patients who had re-ceived maintenance hemodialysis (group A) and 20 healthy people (group B) were enrolled in this study. Group A were further divided into left ventricular hypertrophy group (A1) and non-left ventricular hypertrophy group (A2) ac-cording to the echocardiogram and endothelial diastolic function by Doppler ultrasound. The levels of ADMA and bio-chemical indices were tested. Results Compared with group B [(0.78 ± 0.19) μmol/L], the level of ADMA in group A1 [(1.31±0.24) μmol/L] and A2 [(1.31±0.24) μmol/L] were significantly increased, the differences were statistically significant. The endothelium dependent and independent diastolic function in artery (EDD and EID) were decreased significantly in group A when compared with group B. The EDD of group A1 was significantly lower than that of group A2. Correlation and regression analysis revealed that ADMA, EDD and systolic pressure were the independent factors influencing left ventricular hypertrophy in maintenance hemodialysis patients. Conclusion The ADMA level is significantly increased in uremia patients with maintenance hemodialysis, and the increase of ADMA is closely cor-related with left ventricular hypertrophy.