肾移植患者血清芳香酯酶活性与其基因192位多态性的研究

Research of Arylesterase/paraoxonase 1 activity and its 192 polymorphism in patients with kidney-transplanted

目的研究郑州地区汉族居民肾移植患者血清芳香酯酶(ArE/PON1)活性变化与其基因192位多态性和脂代谢紊乱的关系。方法通过测定肾移植(100例)、慢性肾小球肾炎的引起的尿毒症患者(101例)和对照组(105例)血清ArE/PON1活性、胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL2-C)、高密度脂蛋白2胆固醇(HDL2-C)、高密度脂蛋白3胆固醇(HDL3-C)和氧修饰低密度脂蛋白(oxLDL)等的含量,并用聚合酶链式反应(PCR)分析技术检测了ArE/PON1基因192多态性,进行分析研究。结果肾移植后60d患者血清ArE/PON1活性、ArE/TC、ArE/HDL3-C水平高于尿毒症组,低于对照组,血清HDL-C、HDL2-C和HDL2-C/HDL3-C水平的变化和ArE/PON1活性相似,HDL3-C、NAG/Cr、BUN和SCr水平降低,仍高于对照组水平,血清LDL-C、TC和TG水平反有升高;肾移植和尿毒症组患者血清HDL-C/TC低于对照组,但两组间的差异无统计学意义。ArE/PON1基因192位等位基因Q、R频率健康人基因分别为0.54与0.46,肾移植组为0.51和0.49,尿毒症组0.53与0.47,3组间Q和R基因频率差异无显著性。三组中各组内基因型RR患者血清ArE/PON1与TC、TG、HDL-C、oxLDL等的水平和基因型QR、QQ患者差异无显著性。结论提示原发病为慢性肾小球肾炎的尿毒症肾移植后合并冠心病和基因R无明显关系。血清ArE/PON1活性降低对观察肾移植受者脂代谢紊乱合并心血管疾病则具有临床意义。

[Objective] To investigate the relationship between change of arylesterase/paraoxonase（ArE/PON1）activity and its 192 condon gene polymorphism and dyslipoidoses in patients with transplanted kidney and uremic. [Methods] ArE/PONIQ192R gene polymorphism were detected by PCR, and ArE/PON1 activity, total cholesterol （TC）, high density hpoprotein-cholesteml （HDL-C）, its subclass cholesterol （HDL2-C, HDL3-C）, oxidated low density lipoprotein-eholesteml （oxLDL） were simultaneously determined in serum of patients with kidney transplanted （100）, uremic （101） and healthy population （105）, are all Chinese of Han nationality in Zhengzhou. [Results] After 60 d, kidneys of the patients were transplanted. Levels of serum ArE/PON1 activity, ArE/TC and ArE/HDL3-C were higher than that of uremic, were lower than that of control group. Changes of levels of serum HDL-C, HDL2-C and HDL2-C/HDL3-C were similar to ArE/PON1 activity. Levels of HDL3-C, NAG/Cr, BUN and SCr decreased, but were still higher than that of control group, Levels of serum LDL-C, TC and TG were higher than that of uremic, HDL-C/TC do not different between kidney transplanted and uremic groups, there was still lipid metabolic abnormalities in patients with kidney transplanted. The frequency of the Q allele and R of ArE/PONl192 gene was 0.54 and 0.46 in healthy subjects respectively. 0.51 and 0.49 in patients with kidney transplanted 0.53 and 0.47 in urernie. There were no significant differences that the frequency of the Q and R allele were among three groups. In kidney transplanted group, the levels of ArE/PON1 activity and TC, TG, ete of phenotype RR group was as same as that of other phenotype groups, It is same that of uremic and control groups. [Condusion] These results showed that serum ArE/ PON activity decreased was important for patients with kidney transplanted and uremic developing atheroselerrosis to CHD. There was not relationship between transplanted kidney complicated CHD and frequency of the ArE/PON1192 polymorphism.