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目的 探讨肾移植患者脂代谢紊乱的一般特征及低密度脂蛋白受体 (LDLR)TaqⅠ基因多态性对血脂水平的影响。方法 选择 10 5例肾移植患者为病例组 ,6 0例血脂正常的健康人作为对照。检测空腹血清总胆固醇 (TC)、甘油三酯 (TG)、低密度脂蛋白胆固醇 (LDLC)、高密度脂蛋白胆固醇 (DLC)、载脂蛋白及脂蛋白 (a) [Lp(a) ]水平。采用聚合酶链反应 限制性长度片段多态性方法检测LDLRTaqⅠ基因多态性。结果 病例组于移植后 3个月血脂水平即显著增高 ,于移植后 6个月及1年时进一步升高 ;移植前血清TC、TG高于正常者仅占 2 .9%和 7.6 % ,移植后 3个月增高至 2 8.6 %和 46 .7% (P <0 .0 1) ,移植后 6个月升高至 40 .0 %和 5 9.0 % ,1年时升高至 42 .9%和 6 2 .9% ,较 3个月时显著升高 (P <0 .0 5 )。以TaqⅠ +/ -型人数最多 ,TaqⅠ +/ +型最少 ;对照组Taq基因型分布与病例组的差异无显著性 (P >0 .0 5 ) ;不同基因型的受者血脂水平有所不同 ,多数指标依TaqⅠ - / - 、TaqⅠ +/ - 和TaqⅠ +/ +顺序递减 ;对照组因LDLRTaqⅠ基因型的不同 ,血清TC、LDLC水平的差异具有显著性 ,病例组除TC和LDLC外 ,TG、HDLC和Lp(a)的差异也有显著性。 结论 肾移植术后易发生脂代谢紊乱 ,等位基因LDLRTaqⅠ是脂代谢紊乱发生的危险因子
Objective To investigate the general characteristics of dyslipidemia and the effect of low density lipoprotein receptor (LDLR) Taq Ⅰ gene polymorphism on serum lipids in renal transplant recipients. Methods 105 cases of renal transplant patients as the case group, 60 cases of normal blood lipids healthy people as a control. The levels of fasting serum total cholesterol (TC), triglyceride (TG), low density lipoprotein cholesterol (LDLC), high density lipoprotein cholesterol (DLC), apolipoproteins and lipoprotein (a) [Lp . Polymerase chain reaction restriction fragment length polymorphism was used to detect the polymorphism of LDLRTaq Ⅰ gene. Results In the case group, the level of lipids increased significantly at 3 months after transplantation and further increased at 6 months and 1 year after transplantation. The levels of TC and TG in serum before transplantation were only 2.9% and 7.6% Increased to 22.6% and 46.7% after 3 months (P <0.01), increased to 40.0% and 59.0% 6 months after transplantation, and increased to 42.9% at 1 year And 62.9% respectively, which were significantly higher than those at 3 months (P <0.05). TaqⅠ + / - type and TaqⅠ + / + type were the least. There was no significant difference in the distribution of Taq genotype between the control group and the case group (P> 0.05). The blood lipid levels of the recipients with different genotypes were different , Most of the indexes decreased in the sequence of TaqⅠ - / -, TaqⅠ + / - and TaqⅠ + / +. The differences of LDLRTaq Ⅰ genotype in the control group were significant There was also significant difference between HDLC and Lp (a). Conclusions Lipid metabolism is prone to occur after renal transplantation. The allele LDLRTaq Ⅰ is a risk factor for lipid metabolism disorder