CyPA与慢性肾衰竭相关性及作用研究

目的 研究亲免素A （CyPA）在正常人及慢性肾衰竭（CRF）患者外周血中的浓度水平变化,明确CyPA是否与慢性肾衰竭有关联性及可能的作用机制.方法 CRF患者及正常人对照组各50例,采用ELISA法分别测定（1）正常人外周血CyPA,同时测定AngⅡ、、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）。（2）慢性肾衰竭患者厄贝沙坦治疗前抽取外周血测定CyPA,AngiⅡ、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）水平.治疗1月后再次抽取外周血测定外周血CyPA,AngⅡ、TNFα、IL-6、IL-1α、单核细胞趋化蛋白（MCP-1）水平.比较组间差异及分析CyPA与CRF的相关性及CyPA与AngⅡ、TNFα、IL-6、IL-1α、MCP-1等炎性因子的关联性.结果 （1） CRF组外周血CyPA水平治疗前后均高于健康对照组; （2）在CRF组与正常对照组中,外周血CyPA水平与AngⅡ、TNFα、IL-6IL-1α、MCP-1等存在组间差异（P＜0.01）; （3）经spearman相关分析,在对照组中,慢性肾衰竭治疗前,及慢性肾衰竭氯沙坦治疗后,CyPA均与AngⅡ及TNFα、IL-6、IL-1α、MCP-1有相关性.结论 CyPA可能与AngⅡ协同作用,增加炎性细胞因子趋化水平,促进了CRF患者炎性反应,加重肾小球、肾小管及间质损伤.炎症反应是慢性肾衰竭加速进展的重要原因之一。通过选择性的抑制CyPA或阻断CyPA受体可能为我们提供了一条新的可供选择的治疗途径。

Correlation of CyPA with Chronic Renal Failure

Objective This study was aimed to investigate CyPA concentration levels in the peripheral blood in normal persons and patients with chronic renal failure（CRF）,in order to determine whether CyPA is associated with CRF and its possible mechanism. Methods 50 CRF patients and 50 normal persons were selected. The level of CyPA in the peripheral blood,AngII,TNF,IL-6,IL-1,and monocyte chemoattractant protein（MCP-1） of the normal persons were measured by ELISA. And these indicators of patients with CRF were also measured before and after treatment with irbesartan. The differences between the two groups were compared,the correlation between CyPA and CRF,and the relevance of CyPA with AngII,TNF, IL-6, IL-1 and MCP-1 were analyzed. Results（1） The levels of CyPA in peripheral blood of CRF group were higher than those in control group,whether before or after treatment. There were significant differences in the levels of CyPA,AngII,TNF,IL-6,IL-1 and MCP-1between the CRF group and the control group（P〈 0.01）. The results of Spearman analysis showed that there were correlations between CyPA and the levels of AngII, TNFα,IL-6,IL-1α and MCP-1 in the control group and the CRF group before and after treatment with irbesartan. Conclusion CyPA might played the synergistic effect with AngII and increased the levels of inflammatory cytokines, which revealed that CyPA may act as an inflammatory cell medium,promote inflammatory reaction in CRF patients,increase glomerular,renal tubularand and interstitial injury. CyPA may be a new marker of inflammation in CRF. Inflammation is one of the important causes which speed up the development of CRF. The selective inhibiting or blocking CyPA receptors may provide a new treatment of CR.