Wilcken D E, Gupta V J
Eur J Clin Invest. 1979 Aug;9(4):301-7. doi: 10.1111/j.1365-2362.1979.tb00888.x.
We measured plasma sulphur amino acids in twenty-two patients with chronic renal failure and compared the findings with those obtained in twenty-two normal subjects. In fasting blood (08.00 hours) cysteine-homocysteine mixed disulphide was significantly increased in the renal patients, mean values (+/- SD) being 8.2 +/- 3.4 and 3.1 +/- 1.0 mumol/l respectively (P less than 0.001). The increase was positively correlated with reduced renal function, as assessed by serum creatinine (r = 0.62; P less than 0.01). Homocystine was detected in nineteen patients, the mean concentration (+/- SD) being 1.7 +/- 0.6 mumol/l; it was not found in any normal subject. Methionine levels were not different but there were significant increases in cystine (P less than 0.001) and taurine (P less than 0.05) in the patients. Similar values for these amino acids were found in a second blood sample drawn at 16.00 hours. Changes in the other neutral and acidic amino acids measured were in agreement with those reported in chronic azotaemia. We concluded that plasma levels of all the principal sulphur amino acids except methionine are elevated in chronic renal failure emphasizing the importance of the kidney in sulphur excretion. Prolonged accumulation of homocysteine and cysteine-homocysteine mixed disulphide may be relevant to the development of accelerated vascular disease in patients with chronic renal failure by producing endothelial damage.
我们测定了22例慢性肾衰竭患者的血浆含硫氨基酸水平，并将结果与22名正常受试者的结果进行比较。在空腹血样（上午8点）中，肾衰竭患者的半胱氨酸 - 同型半胱氨酸混合二硫化物显著增加，平均值（±标准差）分别为8.2±3.4和3.1±1.0μmol/L（P<0.001）。这种增加与肾功能降低呈正相关，血清肌酐评估显示（r = 0.62；P<0.01）。在19例患者中检测到同型胱氨酸，平均浓度（±标准差）为1.7±0.6μmol/L；在任何正常受试者中均未发现。蛋氨酸水平无差异，但患者的胱氨酸（P<0.001）和牛磺酸（P<0.05）显著增加。在下午4点采集的第二份血样中发现这些氨基酸的类似值。所测其他中性和酸性氨基酸的变化与慢性氮质血症中报道的一致。我们得出结论，慢性肾衰竭患者除蛋氨酸外所有主要含硫氨基酸的血浆水平均升高，强调了肾脏在硫排泄中的重要性。同型半胱氨酸和半胱氨酸 - 同型半胱氨酸混合二硫化物的长期积累可能通过产生内皮损伤与慢性肾衰竭患者加速血管疾病的发展相关。
