不同原因慢性肾功能衰竭芳香酯酶与脂代谢紊乱的关系

Characteristic of Chronic Renal Function Failure in Patients with Different Primary Disease Analyzed by Arylesterase/Paraoxonase Activity and Lipids Metabolish Disorder

目的 :研究糖尿病慢性肾功能衰竭(DM_CFR)与慢性肾炎慢性肾功能衰竭 (CHN_CRF)患者血清芳香酯酶(ArE/PON1)活性改变与脂代谢紊乱的特点及临床意义。方法 :终点法测定血清ArE/PON1活性 ,酶法测定胆固醇(TC)、高密度脂蛋白胆固醇(HDL_C)及其亚类(HDL2_C)。免疫浊度法测定载脂蛋白 (Apo)A1 和B 100。结果 :糖尿病 (DM )、DN_CRF和CHN_CRF组(各30例)患者血清ArE/PON1活性和HDL_C、HDL2_C、ApoA 1 浓度等均低于对照组(60例) ,TC、oxLDL和ApoB 100 高于对照组 ,以DN_CRF组变化最显著。2组CRF患者血清ArE/PON1活性与HDL_C、HDL2_C、ApoA1、Alb、Ccr呈正相关 ,和oxLDL、TC、ApoB100 和血清肌酐呈负相关。结论 :DN_CFR组ArE/PON1和脂代谢紊乱严重于CHN_CFR ,ArE/PON1活性测定是一种能反映CFR脂代谢紊乱和肾功能损害的指标。

Objective:To explore the characteristics of the changes of serum aryleresterase/paraoxonase(ArE/PON1)and lipids metabolish disorder in chronic renal function failure patients with different primary disease.Methods:Serum ArE/PON1activity,albumin and creatinine were detected by destination technique,and TC,HDLc,HDL 2 c were detected by enzyme technique,apolipoprotein A 1 and B 100 were detected by immune turbidity technique.Results:Thirty cases with diabetic renal failure(DN_CRF),30cases with renal failure resulted from nephritis(CHN_CRF),30cases with diabetes mellitus(DM)and60normal controls were involved in this study.The serum ArE/PON1activity,HDLc,HDL 2 c,and ApoA1were significantly lower than that in control group,and total cholesterol(TC),oxLDL,and ApoB 100 were higher than that in control group.In three patient groups there was a positive correlation between serum ArE/PON1activity and HDLc,HDL 2 c,ApoA 1 ,Alb,Ccr.There was a negative correlation between ArE/PON1and oxLDL,TC,ApoB 100 ,and SCr.Conclusion:Abnormal change of ArE/PON1and dyslipidosis in patients with DN_CRF was more se-rious than that in CHN_CFR.Serum ArE/PON1was one of the good indexes to early inflect the disorder of lipid metabolism of CRF especially for DN_CRF.