肾移植患者ABCA1及GPIHBP1水平与术后血脂的相关性  

Correlation of ABCA1 and GPIHBP1 levels with postoperative blood lipid in uremic patients undergoing renal transplantation

作　　者：刘磊[1] 丰贵文[1] 庞新路[1] 王军祥[1] 王志强[1] 王志刚[1] LIU Lei;FENG Gui-wen;PANG Xin-lu;WANG Jun-xiang;WANG Zhi-qiang;WANG Zhi-gang(Department of Renal Transplantation,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan,CHINA)

机构地区：[1]郑州大学第一附属医院肾移植科,河南郑州450052

出　　处：《海南医学》2024年第17期2492-2496,共5页Hainan Medical Journal

基　　金：河南省高等学校重点科研项目计划(编号:23A320002)。

摘　　要：目的分析尿毒症肾移植患者三磷酸腺苷结合盒亚家族A成员1(ABCA1)及糖基磷脂酰肌醇锚定高密度脂蛋白结合蛋白1(GPIHBP1)水平与术后血脂的相关性。方法回顾性分析2015年3月至2023年1月郑州大学第一附属医院肾移植科收治的97例尿毒症肾移植患者的临床资料,按照术后血脂情况分为血脂正常组(n=34)和血脂紊乱组(n=63),比较两组患者术后1个月、3个月、6个月、12个月的ABCA1、GPIHBP1、血脂(高密度脂蛋白胆固醇、低密度脂蛋白、甘油三酯及总胆固醇)水平和他克莫司血药浓度,采用Pearson相关分析法分析术后ABCA1及GPIHBP1与血脂水平及他克莫司血药浓度的相关性,并比较两组患者随访12个月内并发症的发生情况。结果血脂紊乱组患者术后1个月、3个月、6个月、12个月的ABCA1、GPIHBP1、总胆固醇、甘油三酯、低密度脂蛋白胆固醇及他克莫司血药浓度明显高于血脂正常组,差异均有统计学意义(P<0.05);血脂紊乱组患者术后1个月、3个月、6个月及12个月的高密度脂蛋白胆固醇为(1.05±0.14)mmol/L、(1.14±0.18)mmol/L、(1.18±0.16)mmol/L、(1.23±0.17)mmol/L,均低于同时间段血脂正常组的(1.17±0.21)mmol/L、(1.37±0.28)mmol/L、(1.42±0.24)mmol/L、(1.50±0.32)mmol/L,差异均有统计学意义(P<0.05)。尿毒症肾移植患者的ABCA1与总胆固醇、他克莫司血药浓度呈正相关(P<0.05),与高密度脂蛋白胆固醇呈负相关(P<0.05),而GPIHBP1与总胆固醇、甘油三酯、他克莫司血药浓度均呈正相关(P<0.05)。血脂紊乱组患者的并发症总发生率为49.21%,明显高于血脂正常组的23.53%,差异有统计学意义(P<0.05)。结论尿毒症肾移植患者ABCA1及GPIHBP1基因水平与他克莫司血药浓度及术后血脂水平有一定相关性,检测ABCA1及GPIHBP1基因水平能够为尿毒症肾移植患者术后管理提供一定依据。Objective To analyze the correlation of adenosine triphosphate-binding cassette transporter A1(ABCA1)and glycosylphosphatidylinositol-anchored high-density lipoprotein-binding protein 1(GPIHBP1)levels with postoperative blood lipids in uremic patients undergoing renal transplantation.Methods The clinical data of 97 uremic patients undergoing renal transplantation admitted to Department of Kidney Transplantation,the First Affiliated Hospi-tal of Zhengzhou University from March 2015 to January 2023 were retrospectively analyzed.According to the postop-erative lipid profile,the patients were divided into normal group(n=34)and dyslipidemia group(n=63).The levels of ABCA1,GPIHBP1,blood lipids(high-density lipoprotein cholesterol,low-density lipoprotein cholesterol,triglycer-ide,and total cholesterol),and blood concentration of tacrolimus were compared between the two groups at 1 month,3 months,6 months and 12 months after surgery.The correlation of ABCA1 and GPIHBP1 with blood lipid levels and tacrolimus concentration were analyzed by Pearson correlation analysis,and the incidence of complications with-in 12 months of follow-up between the two groups were compared.Results Serum concentrations of ABCA1,GPIH-BP1,total cholesterol,triglyceride,low-density lipoprotein cholesterol,and tacrolimus were significantly higher in the dyslipidemia group than in the normal group at 1 month,3 months,6 months,and 12 months after surgery(P<0.05).In the dyslipidemia group,the high-density lipoprotein cholesterol at 1 month,3 months,6 months,and 12 months after oper-ation were(1.05±0.14)mmol/L,(1.14±0.18)mmol/L,(1.18±0.16)mmol/L,and(1.23±0.17)mmol/L,respectively,which were significantly lower than(1.17±0.21)mmol/L,(1.37±0.28)mmol/L,(1.42±0.24)mmol/L,and(1.50±0.32)mmol/L in the normal group(P<0.05).ABCA1 was positively correlated with total cholesterol and tacrolimus concentration(P<0.05)and negatively correlated with high-density lipoprotein cholesterol(P<0.05);GPIHBP1 was positively correlated with total cholesterol,triglyceri

关 键 词：尿毒症 肾移植 三磷酸腺苷结合盒亚家族A成员1 糖基磷脂酰肌醇锚定高密度脂蛋白结合蛋白1 血脂 相关性 

分 类 号：R699.2[医药卫生—泌尿科学]