急性肾功能衰竭与氧化损伤  

The relationship between oxidative injury and acute renal failure

作　　者：陈佳兮[1] 胡颖[1] 林莉[1] 周君富[1] 

机构地区：[1]浙江大学医学院附属第二医院肾内科,杭州310009

出　　处：《中华急诊医学杂志》2006年第7期629-632,共4页Chinese Journal of Emergency Medicine

摘　　要：目的测定急性肾功能衰竭患者体内自由基异常反应诱导的氧化损伤。方法采用随机对照研究设计,选择50例急性肾功能衰竭患者(ARF)和50例健康成人志愿者(HAV)。用分光光度测量法分别检测血浆一氧化氮(NO),维生素C(V_C),维生素E(V_E),β-胡萝卜素(β-CAR),血浆和红细胞过氧化脂质(LPO)以及红细胞超氧化物歧化酶(SOD)、过氧化氢酶(CAT)和谷胱甘肽过氧化物酶(GPX)的活性。结果与HAV比较,ARF的血浆NO浓度、血浆和红细胞LPO浓度明显增高(P＜0．01),而血浆V_C、V_E、β-CAR浓度和红细胞SOD、CAT、GPX活性明显下降(P＜0．01)。直线相关分析显示,ARF随着血浆NO水平、血浆和红细胞LPO水平增高,以及血浆V_C、V_E、β-CAR水平和红细胞SOD、CAT和GPX活性下降,血清尿素氮和肌酐水平逐渐增高(P＜0．01)。判别分析显示,ARF的判别正确率为75．3%～93%,HAV为70%～91．3%,逐步判别分析显示,ARF的判别正确率提高到99．2%,HAV提高到100%。可靠性分析显示,ARF的可靠系数(α)为0．816,标准系数α为0．972,P＜0．01。结论在ARF体内,一系列自由基连锁反应呈现严重病理变化,其结果导致氧化损伤,加速肾功能恶化。因此,在ARF的治疗上,加用抗氧化剂非常必要。Objective To study the oxidative injury induced by abnormal free radical reactions in acute renal failure （ARF） patients＇ bodies. Methods Fifty ARF patients and 50 healthy adult volunteers （HAV） were enrolled in a random control study. The levels of nitric oxide （NO） in plasma, lipoperoxide （LPO） in plasma and in erythrocytes, and vitamin C （VC）, vitamin E （VE） and β-carotene （β-CAR） in plasma as well as the activities of superoxide dismutase （SOD）, eatalase （CAT） and glutathione peroxidase （GPX） in erythrocytes were determined with speetrophotometric mothods. Results Compared with the HAV group, the levels of NO in plasma, and LPO in plasma and in erythrocytes in the ARF group were significantly increased （P 〈 0.01）, while levels of VC, VE and β-CAR in plasma as well as SOD, CAT and GPX in erythrocytes in the ARF group were significantly decreased （P 〈 0.01 ）. Linear correlation analysis showed that with the increase of NO and LPO in plasma and in erythrocytes, and with the decrease of VC, VE, β-CAR, SOD, CAT and GPX in the ARF patients, the levels of urea nitrogen and creatinine in serum was gradually increased （P 〈 0.01 ）. The discriminatory correct rates of the above biochemical parameters reflecting oxidative damage of the ARF patients were 75.3 % to 93%, and the correct rates for the HAV were 70.0% to 91.3% when independent diseriminant analysis was used; and the correct rate for the ARF patients was increased to 99.2 %, the correct rate for the HAV was increased to 100 % when stepwise diseriminant analysis was used. The above biochemical parameters＇ reliability coefficient （alpha） were used to estimate the oxidative damage of the ARF patients as 0.816, the standardized item alpha = 0.972, P 〈 0.01. Conclusions A series of free radical chain reactions caused serious pathological aggravation in the ARF bodies, thus resulting in oxidative damage in their bodies. In treating ARF, therefore, it is necessary that suitable dose antioxidants s

关 键 词：急性肾功能衰竭 自由基 氧化作用 NO 脂质过氧化 抗氧化剂 氧化损伤 

分 类 号：R692.5[医药卫生—泌尿科学] R285.5[医药卫生—外科学]