Ⅱ型糖尿病合并高血压患者氧化损伤及抗氧化酶活性的研究  

Oxidative Stress Is Present in NIDDM and Further Enchaned by \;Hypertension

作　　者：刘和俊[1] 汪太平[1] 李芹[1] 史学功[1] 

机构地区：[1]安徽医科大学附属医院心内科,230022

出　　处：《高血压杂志》1999年第3期228-230,共3页Chinese Journal of Hypertension

摘　　要：目的：评价氧化损伤及抗氧化酶活性对型糖尿病（ Ｎ Ｉ Ｄ Ｄ Ｍ）及其伴发高血压（ Ｈ Ｔ）的影响。　方法与结果：采用鲁米诺依赖的中性粒细胞化学发光法，对１３６ 例 Ｎ Ｉ Ｄ Ｄ Ｍ 患者（其中 ７０ 例不伴有 Ｈ Ｔ，６６ 例伴有 Ｈ Ｔ）及３０ 例年龄匹配的健康对照者， 检测其外周血中性粒细胞产生氧自由基（ Ｏ Ｆ Ｒ）的水平。采用化学定量法，测定其血浆脂质过氧化终末产物－ 丙二醛（ Ｍ Ｄ Ａ）的浓度及抗氧化酶－ 超氧化物歧化酶（ Ｓ Ｏ Ｄ）、谷胱甘肽过氧化物酶（ Ｇ Ｓ Ｈ Ｐｘ）的活性。 Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组，其 Ｐ Ｍ Ｎ┐ Ｃ Ｌ 峰值、积分和吞噬指数均明显高于 Ｎ Ｉ Ｄ Ｄ Ｍ 不伴 Ｈ Ｔ组及健康对照组；血浆 Ｍ Ｄ Ａ浓度较后两组也明显升高（ Ｐ均＜ ０．０１）； Ｎ Ｉ Ｄ Ｄ Ｍ 组及 Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组的血浆 Ｓ Ｏ Ｄ和 Ｇ Ｓ Ｈ Ｐｘ 活性较正常对照组均明显降低（ Ｐ均＜ ０．０１）；但与 Ｎ Ｉ Ｄ Ｄ Ｍ 组相比， Ｎ Ｉ Ｄ Ｄ Ｍ 伴发 Ｈ Ｔ组的血浆 Ｓ Ｏ Ｄ 和 Ｇ Ｓ Ｈ Ｐｘ 活性其差异无显著性（ Ｐ均＞ ０．０５）； Ｐ Ｍ Ｎ┐ Ｃ Ｌ峰值与 Ｍ Ｄ Ａ呈明显正相关（ｒ＝ ０．７４８６， Ｙ＝ １５９．８ Ｘ＋ １３２．２， Ｐ＜ ０．０１，Aim:Oxidative stress is believed to play an important role in the development of hypertension associates with diabetes mellitus in animal models.To test this hypothesis in humans,we determined to evaluate the markers of polymorphonuclear leukocyte oxygen free radical( OFR)production,lipid peroxidation and defenses against oxidative stress in NIDDM patients with and without hypertension.\ Methods and Results:A convenient and senstive method for estimation of neutrophil OFR production was assayed by polymorphonuclear leukocyte chemiluminescence(PMN CL).We have measured the parameters of PMN CL, the plasma malondialdehyde(MDA) concentration, the plasma activities of superoxide dismutase(SOD) and glulathione peroxidase(GSHPx) in 136 NIDDM patients( 70 without hypertension and 66 with hypertension) and 30 age matched healthy subjects. Patients with hypertension showed significantly increased PMN CL parameters as peak value(974.8±357.7 mV),integration(149368±74761 mV·s) , and phagocytic index(0.298±0.131 mV·mm -3 ) compared to diabetics without hypertension(572.3±106.8 mV,79038±24137 mV and 0.213±0.079 mV·mm -3 ) and healthy controls(275.9±65.2 mV,36631±9442 mV·s,and 0.078±0.045 mV·mm -3 ).( P <0. 01,respectively). The plasma MDA concentration(4.87±0.13 nmol·ml -1 ) increased in patients with hypertension compared with that in diabetics without hypertension(4.18±0.21 nmol·ml -1 ) and healthy controls(3.42±0.29 nmol·ml -1 ),( P <0.01,respectively).The PMN CL peak value correlated best with plasma MDA concentration ( r =0.7486, P <0.01, n =66) and negatively correlated with the plasma activity of SOD ( r =-0.6471, P <0.05, n =66).\ Conclusion:These data confirm that the oxidative stress was significant in NIDDM patients and was enchaned in diabetic patients with hypertension.

关 键 词：糖尿病 高血压 氧化损伤 病理 

分 类 号：R587.102[医药卫生—内分泌] R544.102[医药卫生—内科学]