尿毒症患者血清不对称性二甲基精氨酸与内皮损伤的相关性  

Correlation between asymmetric dimethylarginine and endothelial dysfunction in patients with ure-mia

作　　者：高丹[1] 胡凤琪[1] 秦永芳[1] 崔龙[1] 明静[1] 袁海[1] 

机构地区：[1]襄阳市中心医院肾内科,湖北省襄阳441021

出　　处：《中国医师杂志》2013年第4期479-481,共3页Journal of Chinese Physician

摘　　要：目的探讨尿毒症患者血清不对称性二甲基精氨酸（ADMA）与动脉内皮损伤的相关性。方法选择新诊断未透析的尿毒症患者40例（A组）和已行血液透析的尿毒症患者45例（B组），并选取正常健康人20例为健康对照组（C组）及20例慢性肾脏病2—4期患者（D组）。应用多普勒超声检测左前臂桡动脉内、中膜厚度和内皮舒张功能。检测各组血清ADMA及各项生化指标水平。结果与C组比较，A组、B组及D组患者血清ADMA的水平均显著升高[（0．78±0．19）μmoL／LVS（1．51±0．16）μmoVL、（1．13±0．14）μmoL／L、（0．92±0．11）μmoL／L，P〈0．05]。与A组比较，B组血清ADMA、CRP[（8．4±1．35）mg/LVS（6．5±0．8）mg/L，P〈0．05]显著降低。与C组比较，A组、B组及D组患者桡动脉内皮依赖性舒张功能[（13．52±1．73）％VS（7．32±0．54）％、（9．02±0．86）％、（10．13±1．25）％，P〈0．05]和非依赖性舒张功能[（14．45±1．85）％VS（10．37±1．51）％、（9．54±1．39）％、（11．17±1．56）％，P〈0．05]均显著下降。B组内皮依赖性舒张功能较A组增加（P〈0．05）。A组血清ADMA含量与内皮依赖性舒张功能呈负相关（r=-0．81，P=0．020）。结论尿毒症患者血清ADMA的显著升高，其升高与动脉内皮功能损伤密切相关。Objective To investigate the correlation between asymmetric dimethylarginine （AD- MA） and endothelial dysfunction in patients with uremia. Methods Uremic patients who did not receive hemodialysis were defined as A group （ n = 40） ; uremic patients who had received hemodialysis were divid- ed into B group （n = 45） ;healthy people were defined as C group （n = 20） ;and chronic kidney disease （ stage 2 - 4） patients were defined as D group （ n = 20）. The diameter of intima-media thickness, and en- dothelium-dependent or independent dilation （EDD or EID ） of radial artery in right forearm were detected with diasonography. The levels of ADMA were determined by high-performance liquid chromatography. Re- stilts Compared to C group, the levels of ADMA in A, B and D groups were significantly increased [ C： （0.78 ±0.19）p, mol/L, A： （l. 51±0.16） μmol/L,B： （1.13±0.14）p, mol/L,D： （0.92±0.11）p, mol/ L ; P 〈 O. 05 ], Compared to A group, the levels of ADMA were significantly decreased in B group （ P 〈 0. 05 ）. EDD and EID were decreased significantly in A, B and D groups compared to C group [ EDD ： C ： （13.52±1.73）% vs A： （7.32 ±0.54）%,B： （9.02 ±0.86）%,D： （10.13±1.25）%, P 〈0.05; EID：C： （14.45±1.85）% vsA： （10.37±1.51）%,B： （9.54±1.39）%,D： （11.17±1.56）%, P 〈 O. 05 ]. EDD in B group was significantly lower than A group （ P 〈 0. 05 ）. In group A, a negative correla- tion was found between EDD and the level of ADMA （ r = - 0. 81, P = 0. 020）. Conclusions ADMA level was significantly increased in uremic patients. A close correlation existed between ADMA and endothe- lial dysfunction of radial artery.

关 键 词：尿毒症 血液 精氨酸 血液 内皮 血管 

分 类 号：R692.5[医药卫生—泌尿科学]