终末期肾病患者血管平滑肌细胞凋亡情况及其影响因素分析  

The Apoptosis of Vascular Smooth Muscle Cell and its Influential Factors in ESRD Patients

作　　者：刘书馨[1] 常明[1] 刘红[1] 王志宏[1] 刘焱[1] 藤兰波[1] 赵华[1] 

机构地区：[1]辽宁省大连市中心医院肾内科,大连116033

出　　处：《中国中西医结合肾病杂志》2007年第5期273-275,共3页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：大连市卫生局基金资助项目(No.2005-150)

摘　　要：目的：观察终末期肾病（ESRD）患者血管平滑肌细胞（VSMC）凋亡情况及其影响因素.方法：在ESRD患者行动静脉内瘘手术时留取桡动脉0.5～1 cm,共43例.年龄相匹配的因外周血管疾病行血管手术4例患者的动脉作为对照,对照组肾功能正常.采用DNA片段原位缺口末端标记技术（TUNEL法）检测上述二组动脉血管平滑肌细胞凋亡情况,结果用凋亡指数表示.临床指标包括血钙、血磷、钙磷乘积、全段甲状旁腺素（iPTH）、血浆白蛋白（Alb）、血红蛋白（Hb）、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白（LDL）、C-反应蛋白（CRP）、丙二醛（MDA）、超氧化物歧化酶（SOD）.采用Pearson相关分析计算凋亡指数与上述临床指标的相关性.结果：ESRD患者的动脉中膜可见到明显的VSMC凋亡,而在对照组血管中膜,只见到极少量凋亡的VSMC.ESRD患者的VSMC凋亡指数与临床指标中的血磷、钙磷乘积、LDL水平呈显著正相关（P＜0.05）.结论：ESRD患者动脉存在明显的VSMC凋亡;血磷、钙磷乘积和LDL升高可能是VSMC凋亡的促进因素.Objective-To investigate the apoptosis of vascular smooth muscle cell （VSMC） and its influential factors in ES- RD patients. Methods：Pieces of radial artery （0.5-1 cm） were taken from 43 ESRD patients at the time of internal arteriovenous fistula operation. Age- matched normal - renal - function patients with periarteriole diseases were included as control. Apoptosis of VSMC was detected by terminal deoxynucleotidyl transferease - mediated biotinylated deoxyuridine triphosphate nick end labeling （TUNEL）, results were measured as apoptosis index （AI）. Related clinical and laboratory parameters were also determined. Results：There were obvious VSMC apoptosis in the medial layer of ESRD patients＇ radial artery. AI of the ESRD group was significantly higher than that of control group （ P〈 0.01 ）. There were few VSMC apoptosis in control group. AI was positively correlated to the level of serum phosphorus, product of serum calcium and phosphorus, and LDL （P 〈 0.05）. Conclusion： There are obvious VSMC apoptosis in the medial layer of ESRD patients＇ radial artery. High level of serum phosphorus, calcium and phosphorus product and LDL may contribute to VSMC apoptosis in ESRD patients.

关 键 词：终末期肾病 血管平滑肌细胞 凋亡 

分 类 号：R692.5[医药卫生—泌尿科学]