慢性肾脏病5期患者桡动脉gremlin表达与血管钙化的关系  

Association of vascular calcification and gremlin expression in radial arteries of patients with stage 5 of chronic kidney disease

作　　者：龚立峰[1] 卢景奎[1] 唐卫刚[1] 姜维 马桂香 

机构地区：[1]江苏大学附属武进医院肾内科,江苏省常州市213002

出　　处：《中华肾脏病杂志》2011年第11期807-810,共4页Chinese Journal of Nephrology

基　　金：常州市武进科技局基金（WS2009006）

摘　　要：目的探讨慢性肾脏病（CKD）5期患者桡动脉中骨形态发生蛋白（BMP）拮抗剂gremlin表达与血管钙化的关系。方法40例CKD5期患者为试验组，于行首次动静脉内瘘术时取桡动脉标本；38例单纯外伤性脾破裂患者为对照组，取其脾小梁动脉标本。用钙盐特异性染色法（vonKossa）对动脉进行钙化染色；用免疫组化法检测动脉gremlin、BMP-2、-7的表达，并用ELISA法检测血清中3者浓度；用病理图像分析系统（IPP6．0）对组织切片进行半定量化图像分析；用SPSS19．0统计分析软件进行数据处理。结果试验组12例（30％）钙盐染色显著阳性，位于中膜的平滑肌细胞层，而对照组无显著钙盐染色。试验组钙盐染色显著阳性的桡动脉均有gremlin、BMP-2显著表达，位于中膜的平滑肌细胞层，且2者的表达量与钙盐染色程度均呈正相关。试验组BMP-7的表达量显著低于对照组。结论gremlin、BMP-2均可能参与了CKD5期患者桡动脉平滑肌细胞向成骨样细胞表型转化这一过程，而BMP-7可能阻止此过程的进展。Objective To study the association of the expression of bone morphogenetic protein （BMP） antagonist gremlin and vascular calcification in radial arteries of patients with stage 5 of chronic kidney disease （CKD）. Methods Radial arteries of 40 patients with stage 5 of CKD were collected as specimens of the study group, which were trimmed off during arterial venous fistula operations. Splenic trabecular arteries were collected as specimens of the control group, which were removed from 38 patients with simple traumatic splenic rupture. All the arteries were examined histologically for calcification with von Kossa stain. Expressions of gremlin and BMP-2, -7 were detected by immunohistoehemistry and their serum concentrations were detected by ELISA. Images of histological sections were semi-quantitatively analyzed by Image-Pro Plus 6.0. SPSS 19.0 software was used to perform statistical analysis. Results Significantly positive von Kossa stain was found in radial arteries from 12 of 40 patients （30%） in study group, which located in the layer of medial smooth muscle cells. However, there was no obvious positive stain in control group. Additionally, in study group, significant expressions of gremlin and BMP-2 were detected in those radial arteries of positive von Kossa stain, which also located in the layer of medial smooth muscle cells. Positive correlations were found among gremlin expression level, BMP-2 expression level and yon Kossa stain intensity. However, the BMP-7 expression intensity in arteries of study group was much weaker as compared to control group. Conclusions Both gremlin and BMP-2 may be involved in the process that the smooth muscle cells of radial arteries in patients with stage 5 of CKD phenotypically transform into osteoblast-like cells. However, BMP-7 possibly prevents this process.

关 键 词：肾疾病 慢性 动脉 钙质沉着症 GREMLIN 骨形态发生蛋白质类 

分 类 号：R692[医药卫生—泌尿科学]