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目的 研究肾脏移植术后高脂血症同转化生长因子 β及其受体mRNA表达之间的关系 ,探讨其导致慢性移植肾病的可能机制与防治措施。方法 肾移植术血脂正常组、血脂增高组及正常对照组各 30例 ,血脂增高组应用辛伐他汀 2 0mg/d进行降脂治疗 ,于服药后 1.5及 3个月复查血脂 ;同时于不同时段应用逆转录聚合酶链反应检测外周血单个核细胞转化生长因子β及其受体mRNA表达。 结果 血脂增高组患者血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平均显著高于血脂正常组及正常对照组 (P =0 .0 0 0 ) ,辛伐他汀降脂治疗 1.5及 3个月后血清总胆固醇、甘油三酯、低密度脂蛋白胆固醇水平呈递减趋势 ,且有显著差异 (P值分别为 0 .0 0 0、0 .0 0 0、0 .0 2 7) ;外周血单个核细胞转化生长因子β及其受体mRNA表达水平按正常对照组、血脂正常组、血脂增高组的顺序递增 ,血脂增高组患者于辛伐他汀治疗后随血脂的下降呈逐步下降趋势。结论 肾移植患者高脂血症可导致转化生长因子 β及其受体mRNA表达水平上调 ,可能是高脂血症引起动脉硬化、慢性移植肾病的机制之一 ;辛伐他汀降脂治疗可使转化生长因子 β及其受体的表达下调 ,有助于减少肾移植患者动脉硬化及慢性移植肾病的发生
Objective To study the relationship between hyperlipemia and TGF-β and its receptor mRNA expression after kidney transplantation and to explore the possible mechanism and prevention and treatment of chronic kidney transplant. Methods Thirty patients with normal blood lipids and hyperlipidemia were enrolled in this study. Thirty patients with hyperlipemia were treated with simvastatin 20 mg daily for lipid lowering. Blood lipid levels were examined at 1.5 and 3 months after drug administration. At the same time, Reverse transcription polymerase chain reaction was used to detect the mRNA expression of transforming growth factor beta and its receptor in peripheral blood mononuclear cells. Results The levels of serum total cholesterol, triglyceride and low density lipoprotein cholesterol in patients with hyperlipidemia were significantly higher than those in normal blood lipids and normal controls (P = 0.0000), and those in simvastatin treatment were 1.5 and 3 The levels of serum total cholesterol, triglyceride and low density lipoprotein cholesterol showed a decreasing trend after a month, with significant difference (P = 0.0000, 0.010, 0.027, respectively); peripheral blood The expression of TGF-β and its receptor mRNA in mononuclear cells increased gradually in the order of normal control group, normal blood lipid group and hyperlipemia group. The serum lipid increased gradually with the decrease of blood lipid after simvastatin treatment. Conclusion Hyperlipidemia in renal transplantation patients may lead to the up-regulation of mRNA expression of transforming growth factor β and its receptor, which may be one of the mechanisms of atherosclerosis and chronic graft-versus-kidney disease in hyperlipidemia. Simvastatin lipid-lowering treatment can lead to the transformation Down-regulation of growth factor beta and its receptor contributes to reducing atherosclerosis and chronic allograft nephropathy in renal transplant recipients