终末期肾病患者血浆同型半胱氨酸及其他氨基硫醇物水平变化  

Plasma concentrations of homocysteine and other aminothiol in end-stage renal disease patients

作　　者：何俊[1] 张晓清[1] 王文娟[1] 丁敏[1] 

机构地区：[1]重庆医科大学医学检验系临床诊断学省部共建教育部重点实验室,400016

出　　处：《中华检验医学杂志》2009年第3期296-299,共4页Chinese Journal of Laboratory Medicine

摘　　要：目的观察终末期肾病（endstagerenaldisease，ESRD）患者血液透析前后血浆同型半胱氨酸（homocysteine，Hcy）及其他氨基硫醇物的水平变化。方法选择慢性维持血液透析患者26例，健康对照组54名。用HPLC．荧光检测法测定血浆总Hey（tHcy）、总半胱氨酸（totalcysteine，tcys）、总半胱氨酰甘氨酸（total cysteinylglycine，tCysGly）、总谷胱甘肽（total Glutathione，tGSH）浓度。同时测定受检者的血脂水平和肾功能。结果ESRD患者血液透析前血浆tHcy、tCys、tCysGly浓度分别为（16．70±3．51）μmol/L、（341．87±70．65）μmol／L和（41．33±32．95）μmol／L，明显高于健康对照组的（10．95±3．07）μmol／L、（249．76±13．18）μmoL／L和（31．3±11．78）μmol／L，差异有统计学意义（t值分别为3．625、6．219和3．530，P均〈0．01）；ESRD患者血液透析前血浆tGSH浓度为（5．91±0．08）μmol／L，低于健康对照组的（9．33±2．62）μmol／L，差异有统计学意义（t=-5．404，P〈0．01）；血液透析后，tHey、tCys浓度分别为（11．74±3．42）μmol／L、（272．67±64．18）txmoVL，较透析前显著降低，但不能恢复至正常水平；血液透析前后tCysGly浓度分别为（41．33±32．95）μmol／L与（44．93±13．88）μmol／L，差异无统计学意义（t=-0．758，P〉0．05）；tGSH浓度分别为（5．91±0．08）μmol／L与（5．93±0．38）μmol／L，差异无统计学意义（t=-0．068，P〉0．05）。患者血浆tHcy与tCys和Cr呈正相关（r值分别为0．7536、0．4582，P均〈0．01），与tGSH呈负相关（r值为-0．6099，P=0．0009），与tCysGly和血脂参数无关。结论ESRD患者普遍存在氨基硫醇物代谢紊乱。Objective To investigate the changes in concentrations of the homocysteine （Hcy） and other aminothiols （ESRD） in plasma of end-stage renal disease （ESRD） patients before and after hemodialysis （HD）. Methods 26 chronic renal failure patients treated with hemodialysis plus 54 healthy controls were randomly chosen. The concentrations of plasma total homocysteine （tHcy）, total cysteine （ tCys）, total cysteinylglycine （ tCysGly ）, total glutathione （ tGSH ） were determined by HPLC-fluorescence detection （FD）. The concentrations of serum lipids were detected and several renal function tests were conducted. Results The concentrations of tHcy（ 16. 70 ± 3.51 μmol/L vs 10. 95 ± 3.07 μmol/L, t = 3, 625 ,P 〈 0. 01 ）, tCys （341. 87 ± 70.65μmol/L vs 249. 76 ± 13.18μmol/L, t = 6, 219, P 〈 0.01 ）, tCysGly（41.33 ±32. 95 μmol/L vs 31.3 ±11.78 μmol/L,t =-3. 530,P 〈0. 01 ） in pre-hemodialysis plasma were significantly elevated , and tGSH （ 5.91 ± 0. 08μmol/L vs 9. 33± 2. 62μmol/L, t = - 5.404, P 〈 0. 01 ） was significantly decreased compared with the control group. The concentrations of they and tCys （11.74 ± 3.42μmol/L and 272. 67±64. 18μmol/L） in post-hemodialysis plasma were significantly decreased compared with in pre-hemodialysis plasma, but they could not be restored to normal levels. However, the concentrations of tCysGly（41.33 ± 32. 95μmol/L vs 44. 93±13.88μmol/L, t = - 0. 758, P〉0.05） and tGSH （5.91±0.08μmol/L vs 5.93±0.38 μmol/L,t = -0.068,P〉0.05） in prehemodialysis plasma and post-hemodialysis plasma didn＇t change significantly. There were significant positive correlations between plasma levels of tHey and tCys（ r = 0. 458 2,P 〈 0. 01 ）. There was significant negative correlations between plasma levers of tHey and tGSH （ r = - 0. 609 9,P = 0. 000 9）. Nevertheless,tHey levels were was not correlated with tCysGly levels and other serum lipid parameters. Conclusion There is a high prevalence of metabolic distur

关 键 词：肾病 肾透析 半胱氨酸 

分 类 号：R686[医药卫生—骨科学]