肾移植受者血清同型半胱氨酸水平的变化

孔祥瑞; 肖漓; 刘志佳; 高钰; 毕丽丽; 石炳毅

doi:10.3969/j.issn.1674-7445.2015.03.009

肾移植受者血清同型半胱氨酸水平的变化

doi: 10.3969/j.issn.1674-7445.2015.03.009

100091 北京，军事医学科学院(孔祥瑞)；解放军第309医院全军器官移植研究所北京市器官移植与免疫调节重点实验室(孔祥瑞、肖漓、刘志佳、高钰、毕丽丽、石炳毅)

基金项目:

国家高技术研究发展计划(863计划) 2012AA021002

详细信息

通讯作者:
石炳毅, Email:shibingyi@medmail.com.cn

中图分类号: R617
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出版历程
- 收稿日期: 2015-03-06
- 网络出版日期: 2021-01-19
- 刊出日期: 2015-05-15

Changes of serum homocysteine level of renal transplant recipients

Military Academy of Medical Science, Beijing 100091, China

More Information

Corresponding author: Shi Bingyi, Email:shibingyi@medmail.com.cn

摘要

摘要: 目的观察肾移植受者移植前后血清同型半胱氨酸(Hcy)水平的变化, 评估其与移植物功能之间的关系。方法横断面回顾性研究选择2013年1月至2014年6月间在解放军第309医院全军器官移植研究所接受首次同种异体肾移植手术且肾功能恢复稳定33例受者为移植组, 经临床检查确诊为慢性肾衰竭(CRF)的患者65例为CRF组, 30名健康体检人员作为对照组。比较各组血清Hcy、血清肌酐(Scr)和血尿素氮(BUN)水平。连续监测移植组在肾移植术前及术后3、7、14、21 d的血清Hcy和Scr水平, 比较肾移植前后血清Hcy水平的变化与肾功能之间的关系。结果 CRF组患者的血清Hcy水平为(25±10)μmol/L, 明显高于对照组的(9±4)μmol/L和移植组稳定期的(15±9)μmol/L, 移植组的血清Hcy水平亦明显高于对照组, 差异均有统计学意义(均为P < 0.001)。CRF组、移植组和对照组的Scr水平分别为(708±302)μmol/L、(98±23)μmol/L、(72±18)μmol/L, CRF组的Scr水平明显高于移植组和对照组, 差异均有统计学意义(均为P < 0.001)。CRF组、移植组和对照组的BUN水平分别为(18.1±5.9)mmol/L、(10.9±5.3)mmol/L、(4.9±1.3)mmol/L, CRF组的BUN水平明显高于移植组和对照组, 差异均有统计学意义(均为P < 0.001), 移植组BUN水平亦高于对照组, 差异有统计学意义(P < 0.001)。移植组患者肾移植术后随着肾功能好转, Scr和血清Hcy水平逐渐降低, 其中术后14 d血清Hcy水平降至最低(15±5)μmol/L, 与术前的(25±10)μmol/L相比, 差异有统计学意义(P < 0.05)。术后14 d内, 移植组肾移植受者的血清Hcy水平与Scr水平呈正相关(r=0.761, P < 0.05)。结论肾移植受者的血清Hcy水平与移植肾功能相关, 联合检测血清Hcy与肾功能指标对预防高Hcy血症和早期评估移植物功能有一定指导意义。
- 肾移植 /
- 同型半胱氨酸 /
- 血清肌酐 /
- 血尿素氮
Abstract: Objective To observe the changes of serum homocysteine (Hcy) level of renal transplant recipients before and after renal transplantation, and assess the correlation between serum Hcy level and graft function. Methods Thirty-three recipients were included into the transplantation group, who underwent renal allograft transplantation in the Organ Transplant Institute of the 309^th Hospital of People's Liberation Army and had renal function recovered stably from January 2013 to June 2014. And 65 patients who were confirmed as chronic renal failure (CRF) by clinical examinations were included into the CRF group and 30 healthy people were included into the control group. A retrospective cross-sectional study was conducted on all of these subjects. Serum Hcy, serum creatinine (Scr) and blood urea nitrogen (BUN) levels of these three groups were compared. Serum Hcy and Scr levels of the transplantation group were continuously monitored before transplantation and at 3, 7, 14 and 21d after transplantation. The correlation between the changes of serum Hcy levels and the renal function before and after transplantation was assessed. Results Serum Hcy level of the CRF group was (25±10) μmol/L, which was significantly higher than (9±4) μmol/L of the control group and (15±9) μmol/L of the transplantation group in stable period, with statistical significance (all in P < 0.001). Serum Hcy level of the transplantation group was significantly higher than that of the control group(P < 0.001). Scr level of the CRF group, the transplantation group and the control group was(708±302)μmol/L, (98±23) μmol/L and (72±18) μmol/L, respectively. Scr level of the CRF group was significantly higher than those of the transplantation group and the control group (all in P < 0.001). BUN level of the CRF group, the transplantation group and the control group was (18.1±5.9) mmol/L, (10.9±5.3) mmol/L and (4.9±1.3) mmol/L, respectively. BUN level of the CRF group was significantly higher than that of the transplantation group and the control group (all in P < 0.001), and BUN level of the transplantation group was significantly higher than that of the control group (P < 0.001). With the improvement in renal function after transplantation, Scr and serum Hcy levels of the transplantation group deceased gradually. At 14 d after transplantation, Hcy level decreased to the minimum of (15±5) μmol/L. Compared with (25±10) μmol/L before transplantation, the difference had statistical significance (P < 0.05). Within 14 d after transplantation, serum Hcy level of the transplantation group was positively correlated with Scr level (r=0.761, P < 0.05). Conclusions Serum Hcy level of the renal transplant recipients is correlated with the graft function. The combined detection of serum Hcy and renal function index has certain guiding significance in the prevention of hyperhomocysteinemia and the early assessment of graft function.
- Renal transplantation /
- Homocysteine /
- Serum creatinine /
- Blood urea nitrogen

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图 1 3组的血清同型半胱氨酸、血清肌酐、血尿素氮水平比较

注：与对照组比较，^aP＜0.001；与移植组比较，^bP＜0.001

Figure 1. Comparison of Hcy, Scr and BUN levels among the three group

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图 2 移植组患者术前和术后各时间点血清同型半胱氨酸和血清肌酐水平的变化

Figure 2. Changes of Hcy and Scr levels of patients in transplantation group at each time point before and after renal transplantation

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