血清可溶性FasL水平与尿毒症患者心血管疾病的相关性研究  

Correlation between soluble Fas ligand and cardiovascular disease in uremia patients

作　　者：李德谦[1] 梅长林[1] 孙田美[1] 沈学飞[1] 戴兵[1] 

机构地区：[1]第二军医大学长征医院肾内科,上海200003

出　　处：《解放军医学杂志》2005年第7期628-631,共4页Medical Journal of Chinese People's Liberation Army

摘　　要：目的探讨尿毒症心血管疾病(CVD)患者血清可溶性FasL(sFasL)水平与相关因子和颈总动脉血管内膜中层厚度(IMT)的相关性。方法尿毒症血液透析伴CVD患者103例(CVD组);尿毒症血液透析不伴CVD患者31例(非CVD组)。采用酶联免疫双抗体夹心法(ELISA)测定血清sFasL、CRP、白蛋白、IL6和TNFα浓度。免疫组化观察桡动脉血管内皮细胞的Fas、FasL表达;采用荧光逆转录聚合酶链式反应(RTPCR)测定Fas、FasLmRNA的含量;彩色超声波测量颈总动脉血管内膜中层厚度(IMT)。结果CVD组血清sFasL、CRP、IL6和TNFα浓度显著高于非CVD组(P<0.01),白蛋白则低于非CVD组(P<0.01)。CVD组血管壁Fas、FasL表达明显高于非CVD组。荧光RTPCRFas、FasLmRNA定量分析示CVD组较非CVD组增高50%。CVD组63.11%(41/65)患者IMT增厚。双变量线性相关分析示,sFasL与CRP和IMT均呈明显的正相关(r=0.58,r=0.64,P<0.01);与白蛋白水平及GFR呈负相关(r=-0.53,r=-0.62,P<0.01)。结论血清sFasL水平及血管壁Fas、FasL高表达可能与动脉粥样硬化相关,因此血清sFasL水平可能是尿毒症CVD患者一个新的危险因素。Objective To investigate the correlation of serum sFasL level with carotid arterial intima- media thickness(IMT) and some known markers of inflammation, nutritional status in uremic patients with cardiovascular disease(CVD). Methods 134 uremic patients on hemodialysis were divided into two groups, CVD group (n=103) and non-CVD group (n=31). The serum level of sFasL, C-reactive protein (CRP), IL-6, TNF-α and albumin were measured by enzyme-linked immunosorbent assays (ELISA). The expression of Fas and FasL in radial arterial endothelial cells were observed both by immuohistochemical stain and by reverse transcription- polymerase chain reaction (RT-PCR). The Carotid arterial IMTs were measured by Color doppler ultrasonography. Results Compared with the non-CVD group, CVD group showed significantly increased serum sFasL, CRP, IL-6, and TNF-α, and decreased serum albumin(P<0.01). Remarkable up-regulation of Fas and FasL in radial arterial endothelial cells of the CVD group was observed both in immuohistochemistrical stain and in fluorescent RT-PCR assay (mRNA was 50% higher than that in non-CVD group). 41 (63.11%) patients in CVD group presented an increase of IMT. Bivariate correlation analysis showed that sFasL correlated positively with CRP and IMT (r=0.58 and 0.64 respectively, P<0.01), while correlated negatively with serum albumin and GFR(r=-0.53 and -0.62, P<0.01). Conclusion Serum sFasL increases significantly in uremic patients with CVD. Therefore, it′s inferred that serum sFasL is likely to be a novel risk factor of cardiovascular disease in uremic patients

关 键 词：可溶性FASL 尿毒症 心血管疾病 炎症 

分 类 号：R692.5[医药卫生—泌尿科学]