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心脏移植受者中的肾酶与内皮功能障碍

Renalase and endothelial dysfunction in heart transplant recipients.

作者信息

Przybylowski P, Koc-Zorawska E, Malyszko J S, Mysliwiec M, Malyszko J

机构信息

Cardiovascular Surgery and Transplantology, Jagiellonian University, Krakow, Poland.

出版信息

Transplant Proc. 2013 Jan-Feb;45(1):394-6. doi: 10.1016/j.transproceed.2012.02.042.

Abstract

INTRODUCTION

Renalase, an enzyme that cetabolyzes catecholamines, such as circulating adrenaline and noradrenaline, is released by the human kidney to regulate blood pressure. In solid organ transplant recipients endothelial dysfunction is often present. The aim of our study was to assess correlations among renalase, blood pressure, endothelial injury markers, and kidney function in 130 prevalent heart allograft recipients (OHT).

METHODS

Complete blood counts, urea, serum lipids, fasting glucose and creatinine were measured using standard laboratory methods in the hospital central laboratory. We assessed markers of endothelial function/injury: vWF (von Willebrand factor), inflammation: hsCRP, interleukin (IL)-6, TRAIL (tumor necrosis factor related apoptosis-inducing ligand), TWEAK (tumor necrosis factor-like weak inducer of apoptosis) and midkine renalase using commercially available kits.

RESULTS

The mean serum renalase among OHT was significantly higher compared with a control group (P < .001). Among heart transplant recipients renalase correlated weakly (P < .05) with time after transplantation and TRAIL; moderately (P < .01), with ejection fraction and age; and strongly, with kidney function, IL-6, vWF, midkine, and New York Heart Association class (P < .05). Multiple regression analysis revealed renalase values to be 70% predicted by serum creatinine measurements.

CONCLUSION

Impaired kidney function was strongly associated with endothelial damage and inflammation. Renalase, which was highly elevated among heart transplant recipients, was predominantly dependent on renal function, which deteriorated with time after transplantation and in correlation with age.

摘要

引言

肾酶是一种可分解儿茶酚胺(如循环中的肾上腺素和去甲肾上腺素)的酶,由人体肾脏释放以调节血压。实体器官移植受者常存在内皮功能障碍。我们研究的目的是评估130例心脏移植受者中肾酶、血压、内皮损伤标志物和肾功能之间的相关性。

方法

在医院中心实验室采用标准实验室方法测量全血细胞计数、尿素、血脂、空腹血糖和肌酐。我们使用市售试剂盒评估内皮功能/损伤标志物:血管性血友病因子(vWF)、炎症标志物:高敏C反应蛋白(hsCRP)、白细胞介素(IL)-6、肿瘤坏死因子相关凋亡诱导配体(TRAIL)、肿瘤坏死因子样凋亡弱诱导剂(TWEAK)和中期因子以及肾酶。

结果

与对照组相比,心脏移植受者的平均血清肾酶水平显著更高(P <.001)。在心脏移植受者中,肾酶与移植后时间和TRAIL呈弱相关(P <.05);与射血分数和年龄呈中度相关(P <.01);与肾功能、IL-6、vWF、中期因子和纽约心脏协会分级呈强相关(P <.05)。多元回归分析显示,血清肌酐测量可预测70%的肾酶值。

结论

肾功能受损与内皮损伤和炎症密切相关。心脏移植受者中肾酶水平显著升高,主要依赖于肾功能,肾功能随移植后时间推移以及与年龄相关而恶化。

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