肾移植患者检测血清同型半胱氨酸水平的意义

The significance of serum homocystein test for renal transplant patients

目的探讨肾移植患者检测血清同型半胱氨酸(Hcy)水平的意义。方法选择门诊随访的肾移植患者445例作为肾移植组;选择健康体检者100例作为对照组。分别测定各组研究对象血清Hcy、肌酐(Cr)、半胱氨酸蛋白酶抑制剂C(CysC)。根据美国国家肾脏基金会——肾脏病预后质量倡议(NKF-K/DOQI)原则将患者按照肾小球滤过率(eGFR)水平分为6个组(≥90、60~<90、45~<60、30~<45、15~<30、<15),比较各组患者血清Hcy、Cr水平,分析血清Hcy与抗排异药物的关系。结果各eGFR组患者血清Hcy水平明显高于对照组,差异均有统计学意义(P<0.05)。服用不同抗排异药物组患者血清Hcy水平比较差异均无统计学意义(P>0.05)。肾移植组患者血清CysC、Cr水平与Hcy水平明显相关(r=0.481、0.456,P<0.05)。eGFR≥90组患者血清CysC水平明显高于对照组,差异有统计学意义(P<0.05)。结论肾移植患者血清Hcy水平与健康体检者有差异,且随eGFR水平下降血清Hcy水平逐渐增高,与血清CysC、Cr水平均明显相关。eGFR≥90患者血清Hcy水平与健康体检者有差异,与血清CysC水平与健康体检者有差异相符。肾移植患者服用不同抗排异药物对血清Hcy水平无影响。

Objective To investigate the significance of testing serum homocysteine for renal transplant patients.Methods 445 renal transplant patients from outpatient follow-up(renal transplant group)and 100 healthy subjects(control group)were enrolled in the study,whose serum homocysteine(Hcy),Cystatin C(CysC),creatinine(Cr)were tested.Then according to the eGFR(refered to the principle of NKF-K/DOQI)patients of renal transplant group were divided into six subgroups.Serum levels of Hcy and Cr were compared among different groups,and the relationship between serum Hcy concentration and anti-rejection drugs were analyzed.Results In the transplant group,concentrations of Hcy were obviously higher than that in control group(P<0.05).There was no significant difference in Hcy concentrations among renal transplants who had taken different anti-rejection drugs(P>0.05).Concentrations of CysC and Cr were significantly associated with Hcy in renal transplant group(r=0.481,0.456,P<0.05).There was significant difference between eGFR≥90subgroup and control group in CysC concentration(P<0.05).Conclusion Concentration of Hcy in renal transplant group was obviously higher than that in control group.With the eGFR decreased,Hcy increased gradually,and in transplant group was associated with the concentration of CysC and Cr.There was significant difference between eGFR≥90subgroup and control group in Hcy and CysC concentrations(P<0.05).The different anti-rejection drugs had no effect on serum Hcy levels.