血液透析患者血清脂肪细胞型脂肪酸结合蛋白水平与动脉粥样硬化相关性的初步探讨

目的 观察血液透析（hemodialysis,HD）患者血清脂肪细胞型脂肪酸结合蛋白（adiopocyte fatty acid binding protein,A-FABP,FABP4）的变化,并初步探讨其与HD动脉粥样硬化（atherosclerosis,AS）的相关性.方法 选取HD患者29例为研究对象（HD组）,20例健康体检者为对照（HC组）,应用酶联免疫吸附试验（ELISA）测定2组血清A-FABP、白细胞介素-6（interleukin-6,IL-6）、单核细胞趋化蛋白-1（monocyte chemotactic protein 1,MCP-1）的水平.采用彩色多普勒超声技术测定患者颈总动脉内膜-中层（intima-media thickness,IMT）厚度.再根据是否伴有大血管病变,将HD组分为HD合并AS组（HD＋AS组）、HD不合并AS组（HD-AS组）.结果 HD组患者与HC组比较,血清A-FABP、FFA水平显著升高（P＜0.05）.经pearson相关分析,A-FABP与FFA存在显著相关（r=0.939,P＜0.01）,A-FABP与IL-6、MCP-1亦存在正相关关系.HD＋AS组患者血清A-FABP水平高于CKD-AS组,且存在统计学差异（P＜0.01）.结论 HD患者血清A-FABP及FFA水平高于健康人群,AS的形成可能与血清A-FABP水平的升高有关.推测A-FABP可能主要通过促进炎症反应和活化巨噬细胞参与AS的形成.

The relationship between serum adiopocyte fatty acid binding protein and atherosclerosis in hemodialysis patients

Objective To investigate the changes of serum adiopocyte fatty acid binding protein （A- FABP, FABP4） and its correlation to atherosclerosis in hemodialysis patients. Methods Twenty-nine hemo- dialysis patients and 20 health controls were involved in this study. Serum A-FABP, free fatty acids （FFA）, IL- 6, monocyte chemotactic protein I （MCP-1） were measured by enzyme-linked immunosorhent assay （ELI- SA）. Intima-media thickness was measured by color Doppler ultrasonography. Results Serum A-FABP and FFA were higher in hemodialysis patients than in healthy controls （P〈0.05）. In hemodialyis patients, serum A-FABP level was positively correlated with serum FFA level （r=0.939, P〈0.01）, IL-6, and MCP-1. Serum A- FABP was higher in the 19 hemodialysis patients with vascular atherosclerosis than in the 10 hemodialysis pa- tients without vascular atherosclerosis （P〈0.0 1）. Conclusion Serum A-FABP may play an important role in the progression of vascular atherosclerosis in chronic kidney disease patients.