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维持性血液透析患者血清甲状旁腺激素水平与心功能及生存质量的相关性研究 被引量:24
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作者 吴琳虹 张萌 +2 位作者 陈兴强 韦明辉 符薇薇 《中国现代医学杂志》 CAS 2019年第2期112-117,共6页
目的探讨维持性血液透析(MHD)患者血清甲状旁腺激素(PTH)水平与心功能及生存质量的相关性。方法选取2015年9月—2017年9月在海南省三亚市人民医院行MHD治疗≥3个月的109例MHD患者,按照PTH水平将其分为PTH<500 pg/ml(A组41例)、500~8... 目的探讨维持性血液透析(MHD)患者血清甲状旁腺激素(PTH)水平与心功能及生存质量的相关性。方法选取2015年9月—2017年9月在海南省三亚市人民医院行MHD治疗≥3个月的109例MHD患者,按照PTH水平将其分为PTH<500 pg/ml(A组41例)、500~800 pg/ml(B组32例)及>800 pg/ml(C组36例)。采用彩色多普勒超声诊断仪检测患者心功能指标,肾脏病生存质量KDQOL-SFTM量表调查患者生存质量。分析PTH与患者心功能指标及生存质量的相关性。结果 3组心功能指标比较,差异有统计学意义(P <0.05);B、C组LVD、LVDD、LVPWT、IVST、LVM及LVMI高于A组,LVEF低于A组,且C组LVD、LVDD、LVPWT、IVST、LVM及LVMI高于B组,LVEF低于C组(P <0.05)。3组SF-36、肾病和透析相关生存质量及总体健康评估评分,经方差分析,差异有统计学意义(P <0.05),B、C组SF-36、肾病和透析相关生存质量及总体健康评估评分低于A组,且C组低于B组(P <0.05)。B、C组SF-36各维度评分低于A组,C组低于B组;B、C组肾病和透析相关生存质量维度中的症状与不适、肾病对生活的影响、社交质量、睡眠及患者满意度评分低于A组,C组症状与不适、肾病对生活的影响、社交质量、患者满意度评分低于B组(P <0.05)。MHD患者血清PTH水平与心功能指标中LVD、LVDD、LVPWT、IVST、LVM及LVMI呈正相关(P <0.05),与LVEF、生存质量中SF-36、肾病和透析相关生存质量及总体健康评估呈负相关(P <0.05),其中PTH与躯体健康、躯体角色功能、躯体疼痛、总体健康、精力、症状与不适、肾病对生活的影响、社交质量、性功能、睡眠及患者满意度呈负相关(P <0.05)。结论 MHD患者存在不同程度的PTH水平升高,其与患者心功能、生存质量有相关性。早期检测有助于评估患者病情,从而指导临床采取针对性干预措施。 展开更多
关键词 血液透析滤过 受体 甲状旁腺激素 心房功能 心室功能 生存质量/生活质量
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Glutaminolysis and α-ketoglutarate-stimulated K_(Ca)3.1 expression contribute to β-adrenoceptor activation-induced myocardial fibrosis in mice
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作者 Ru-Yue Bai lin-hong wu +13 位作者 Yan Wang Chen Guo Gang She Zheng-Da Pang Jing-Jing Li Xin-Yi Zhao Meng-Zhuan Han Xia-Xia Hai Yi-Yi Yang Yi Zhang Li-Mei Zhao Lian-Ying Jiao Xiao-Jun Du Xiu-Ling Deng 《Science China(Life Sciences)》 2025年第7期2043-2057,共15页
Heart failure is associated with myocardial fibrosis,a pivotal histopathological feature arising from β-adrenergic receptor(β-AR) stimulation through sympathetic nervous system activation.Augmented glutaminolysis wi... Heart failure is associated with myocardial fibrosis,a pivotal histopathological feature arising from β-adrenergic receptor(β-AR) stimulation through sympathetic nervous system activation.Augmented glutaminolysis with increased bioavailability of α-ketoglutarate(α-KG) is suggested to contribute to fibrogenesis and changes in cellular gene expression.K_(Ca)3.1 is a calcium-activated potassium channel expressed in fibroblasts and has been implicated in mediating fibrosis,yet the putative interactions between glutaminolysis and K_(Ca)3.1 in β-ARmediated cardiac fibrosis remain poorly understood.Here,we performed a series of in vitro and in vivo experiments to investigate how α-KG might influence the expression of K_(Ca)3.1 in the context of experimental myocardial fibrosis driven by β-AR activation.In cultured adult mouse cardiac fibroblasts,α-KG exposure resulted in the upregulation of K_(Ca)3.1 m RNA and protein levels that were commensurate with the dose and duration of exposure,and also led to increased K_(Ca)3.1 channel currents.Exposure to α-KG led to a significant decrease in levels of histone methylation(H3K27me3) within the K_(Ca)3.1 promoter,a decrease in the association of the transcription repressor REST from this site,as well as an enrichment of transcription activator AP-1 binding.The exacerbated fibrotic signaling induced by α-KG in cultured fibroblasts was suppressed by functional inhibition of K_(Ca)3.1 or by genetic knockdown of Kcnn4.Moreover,β-AR activation by isoproterenol significantly augmented glutaminolysis mediated by glutaminase 1(GLS1) and significantly increased α-KG levels detected in the supernatant of cultured fibroblasts and cardiomyocytes.In addition,isoproterenol-induced K_(Ca)3.1 expression in fibroblasts was curtailed by treatment with the GLS1 inhibitor CB-839,or by GLS1 gene knockdown,or by treatment with the selective β_2-AR antagonist,ICI118551.In mouse models of established cardiac fibrosis evoked by isoproterenol-stimulation or β_2-AR overexpression,treatment with CB-839 for 4 weeks suppressed the phenotypic features of fibrosis,and this was associated with a decline in α-KG tissue content,a lack of histone demethylation at the K_(Ca)3.1 promoter,as well as suppression of K_(Ca)3.1 expression.Taken together,our study demonstrates for the first time that glutaminolysis contributes to β-AR activation-induced myocardial fibrosis via α-KG-stimulated K_(Ca)3.1 expression.We anticipate that treatments which target the β-AR/GLS1/α-KG/K_(Ca)3.1 signaling pathway might be effective for cardiac fibrosis. 展开更多
关键词 cardiac fibrosis β-adrenergic receptor GLUTAMINOLYSIS Α-KETOGLUTARATE K_(Ca)3.1 channels
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