肾移植患者血清非对称二甲基精氨酸水平变化与内皮功能改善的关系(英文)

Serum asymmetric dimethylarginine and endothelial function after renal transplantation

目的:探讨肾移植前后慢性肾衰患者血清非对称二甲基精氨酸(ADMA)水平变化与内皮功能改善的关系。方法:选择首次接受同种异体肾移植术患者38例和健康对照者36例。分别于移植术前、移植术后第1,3,7,14及28天抽血分离血清,高效液相色谱法(HPLC)检测血清ADMA和SDMA水平,硝酸还原酶比色法检测血清NO活性,DTNB法测定全血硒谷胱甘肽过氧化物酶(SeGSHPx)活性,,硫代巴比妥酸法测定血清丙二醛(MDA)水平,ELISA法检测血清C反应蛋白(CRP)水平;移植术前及术后第28天多普勒超声法检测肱动脉内皮依赖性血管舒张功能(FMD)。结果:肾移植术前患者血清ADMA[(2.36±0.89)μmol/L],SDMA[(0.48±0.11)μmol/L],MDA[(7.24±1.07)μmol/L]及CRP水平[9.24(0.42～66.24)μmol/L]明显高于年龄匹配的正常对照组[ADMA:(0.49±0.12)μmol/L;SDMA:(0.24±0.08)μmol/L;MDA:(3.12±1.21)μmol/L;CRP:2.52(0.24～5.94)μmol/L,均P<0.01],血清NO[(38.48±12.36)μmol/L]及SeGSHPx[(104.23±14.46)U/L]活性、FMD(5.43%±1.87%)明显低于正常对照组[NO:(70.13±12.46)μmol/L;SeGSHPx:(201.36±82.35)U/L;FMD:(10.11±1.64)%,均P<0.01]。移植术后第1天开始血清ADMA[(1.97±0.76)μmol/L],SDMA[(0.43±0.06)μmol/L],MDA[(6.24±0.82)μmol/L]及CRP[8.32(0.46～33.42)μmol/L]水平明显下降而血清NO[(42.63±11.32)μmol/L],SeGSHPx[(116.23±17.24)U/L]活性明显增高,第28天时除SDMA水平与对照组无差别外(P>0.05),其余指标仍高于或低于正常对照组(P<0.05)。第28天时FMD(7.04±2.13)%较移植前明显增高但仍低于正常时对照组(P<0.05)。移植前后血清ADMA水平与MDA呈正相关,与SeGSHPx及FMD呈负相关。结论:慢性肾衰患者移植前后血清ADMA水平变化与内皮功能异常关系密切,并与氧化应激程度相关。

Objective To investigate the relation between serum asymmetric dimethylarginine(ADMA)level and endothelial function before and after living donor kidney transplantation in uremic patients.Methods A total of 38 renal transplant patients(21males and 17 females)and 36 healthy controls(20 males and 16 females)were enrolled.Plasma ADMA,symmetric dimethylarginine(SDMA),malondialdehyde(MDA),glutathione peroxidase(SeGSHPx),C-reactive protein(CRP)were mea-sured before transplantation and on Days 1,3,7,14,and 28 post...