维持性血液透析患者血管平滑肌细胞p53的表达与血管钙化的关系  

Relationship Between Expression of p53 in Vascular Smooth Muscle Cells and Vascular Calcification in Maintenance Hemodialysis Patients

作　　者：李开龙[1] 苏楠[2] 詹俊[1] 王惠明[1] 赵玲[2] 何娅妮[1] 

机构地区：[1]中国人民解放军第三军医大学大坪医院野战外科研究所肾内科,重庆市400042 [2]中国人民解放军第三军医大学创伤烧伤与复合伤国家重点实验室,重庆市400042

出　　处：《中国动脉硬化杂志》2009年第1期31-34,共4页Chinese Journal of Arteriosclerosis

基　　金：重庆市自然科学基金(CSTC;2008BB5275)

摘　　要：目的探讨维持性血液透析患者血管平滑肌细胞p53的表达与血管钙化的关系。方法选择慢性肾脏疾病5期维持性血液透析患者17例(透析时间在1年以上),均为自体桡动脉-头静脉内瘘作为透析通路的患者,因自体动静脉内瘘失功拟重建血管通路。在动静脉内瘘重建过程中,取失功动静脉内瘘动脉段作为实验组标本,同龄人群(取材于尸体肾供者)腹主动脉作为对照组。以von Kossa染色法对血管钙化进行定性检测,甲酚酞络合酮化学法对血管钙化进行定量检测,磷酸苯二钠法测定血管组织碱性磷酸酶活性,Western blotting检测血管组织p53蛋白水平,并对血管钙含量和碱性磷酸酶活性与p53的表达进行相关性分析。结果维持性血液透析患者桡动脉血管平滑肌细胞p53的表达(p53/β-actin灰度比为0.81)显著低于同龄人群腹主动脉血管平滑肌细胞p53的表达(p53/β-actin灰度比为1.72),而血管平滑肌细胞钙含量和碱性磷酸酶活性分别较同龄人群腹主动脉血管平滑肌细胞增加69%和105%(P均<0.01)。相关性分析发现,p53的表达与血管平滑肌细胞钙含量和碱性磷酸酶活性均成显著负相关(r=-0.77和r=-0.86,P均<0.01)。结论在5期慢性肾脏疾病维持性血液透析患者中血管钙化广泛存在,血管钙化伴随着血管平滑肌细胞p53蛋白表达的显著下降,这一现象提示慢性肾脏疾病患者血管平滑肌细胞p53表达的抑制可能参与了血管钙化的发生机制。Aim To determine the relationship between the expression of p53 protein in vascular smooth muscle cells （ VSMC ） and vascular calcification in maintenance hemodialysis patients with end-stage renal disease （ chronic kidney disease stage V （ CKD-V） ）. Methods 17 maintenance hemodialysis patients with a autologous arteriovenous fistula （ AVF ） used for more than 1 year were referred for hemodialysis vascular acees reonstruction between July 2007 and July 2008, because of their primary AVF dysfunction. 17 artery segments （ HD group ） from dysfunctional AVF during the vascular aeees reconstruction and 8 abdominal aorta segments （control group） from cadaver kidney donors with the same age were collected as samples. Van Kossa histochemistry served as qualitative indicators of vascular calcification, cresolphthalein complexone chemical method served as quantification analysis of vascular calcification, and alkaline phosphatase （ALP） activity assay was performed following the assay kit. The expression of p53 protein in VSMC was analyzed by Western blotting, and the relationship between the expression of p53 protein in VSMC and vascular calcification in maintenance hemodialysis patients with CKD-V was analyzed. Results The expression of p53 protein （ p53/13-actin gray scale = 0.81 ） in HD group was significantly lower than that （ p53/β-actin gray scale = 1.72 ） in control group （ P 〈 0.01 ） , but 69% of the calcium contents and 105% of the ALP activity in HD group was increased compared with that in control group （ P 〈 0.01 ）. The expression of p53 was negatively related to the calcium contents and the ALP activity in VSMC （ r = - 0.77 and r = - 0.86, P 〈 0.01 ）. Conclusion Vascular calcification is extensively presented in maintenance hemodialysis patients with CKD-V, which is accompanied by the decreased expression of p53 in VSMC. This result implys that the expression inhibition of p53 in VSMC may be involved in the pathogenesis of vascular calcification.

关 键 词：维持性血液透析 血管钙化 P53 碱性磷酸酶 血管平滑肌细胞 

分 类 号：R5[医药卫生—内科学]