维持性血液透析患者血清ADMA水平影响因素分析  

Analysis of the risk factors on the levels of ADMA in maintenance hemodialysis patients

作　　者：赵方圆[1] 徐金升[1] 白亚玲[1] 张俊霞[1] 崔立文[1] 张慧然[1] 张胜雷[1] 

机构地区：[1]河北医科大学第四医院,石家庄050011

出　　处：《山东医药》2013年第9期17-19,23,共4页Shandong Medical Journal

基　　金：河北省自然科学基金资助项目(H2012206157)

摘　　要：目的分析影响维持性血液透析(MHD)患者血清非对称性二甲基精氨酸(ADMA)水平的因素。方法选择行MHD的终末期肾脏病(ESRD)患者126例,记录年龄、性别、吸烟、糖尿病、透析龄、透前收缩压、舒张压。采用高效液相色谱—质谱联用法(HPLC-MS)测定血清ADMA浓度。提取全血DNA,用Snapshot基因测序法确定DDAH-2(-449G/C)单核苷酸基因多态性。将血清ADMA水平与各变量之间进行统计分析。结果 DDAH-2(-449G/C)基因型GG、CG、CC患者血清ADMA浓度差异无统计学意义(P>0.05);血压升高、长透析龄、透前收缩压升高、胆固醇升高患者的ADMA水平较高(P均<0.05)。经多元线性回归分析,透析龄、透前收缩压及血清总胆固醇水平是影响血清ADMA水平的独立危险因素。结论透析龄、透前收缩压及血清总胆固醇水平是影响行MHD患者血清ADMA水平的独立危险因素。DDAH-2(-449G/C)单核苷酸基因的多态性可能对中国行MHD患者的ADMA水平无影响作用。Objective To investigate the risk factors of ADMA in maintenance hemodialysis patients. Methods A total of 126 MHD patients were selected as subjects and their age, gender, smoking, diabetes meUitus, duration of dialy- sis, systolic blood pressure and diastolic blood pressure before dialysis were recorded. Before hemodialysis, the serum AD- MA concentration was determined by method of HPLC-MC. DNA was obtained from blood samples. The polymorphisms of DDAH-2 （-449G/C） were detected by Snapshot gene sequencing. The relationships between the serum level of ADMA and the variables were statistically analyzed. Results There were no statistical differences of the serum ADMA concentra- tion between GG, CG, CC genotypes of the DDAH-2（ -449 G/C） （P 〉0.05）. The serum ADMA level was higher in pa- tients with elevation of blood pressure, long dialysis age, high predialysis systolic pressure and high-CHOL （ P 〈 0.05 ）. By multiple linear regression equation, dialysis age, predialysis systolic pressure and CHOL were the independent risk fac- tors effecting ADMA level in the MHD patients. Conclusions Dialysis age, predialysis systolic pressure and CHOL are the independent risk factors for the serum ADMA levels of MHD patients. The single nueleotide polymorphisms of DDAH- 2 （-449G/C） may have no effect on the serum ADMA levels in MHD patients of China.

关 键 词：维持性血液透析 单核苷酸基因多态性 非对称性二甲基精氨酸 二甲基精氨酸二甲胺水解酶 

分 类 号：R331[医药卫生—人体生理学]