腹膜透析患者血清BNP水平与氧化应激状态的关系  

The relationship between serum B-type natriuretic peptide and oxidative stress in patients on peritoneal dialysis

作　　者：李绍梅[1] 平立英[1] 于连英[1] 吴晓磊[1] 卢素玉[1] 鲁宁[1] 

机构地区：[1]河北医科大学第二医院肾内科 河北省腹膜透析治疗中心,石家庄050000

出　　处：《中国血液净化》2015年第2期70-74,共5页Chinese Journal of Blood Purification

摘　　要：目的探讨维持性腹膜透析患者血清脑钠肽（B-type natriuretic peptide,BNP）与氧化应激的关系。方法选取持续非卧床性腹膜透析（Continuous ambulatory Peritoneal dialysis,CAPD）患者81例,12名尿检正常的健康体检者作为对照组。氧化应激指标采用血清晚期过氧化物（Advanced oxidation protein,AOPP）,超氧化物歧化酶（superoxide dismutase,SOD）,丙二醛（maleic dialdehyde,MDA）。根据血BNP不同程度分为3等分组：A组BNP〈128.63pg/ml、B组BNP128.63~211.65pg/ml和C组BNP〉211.65 pg/ml,分析BNP与氧化应激状态及临床指标的关系。结果 CAPD患者氧化应激指标血清AOPP、MDA和BNP均显著高于正常对照组,而SOD水平明显低于对照组。AOPP水平在BNP升高组[B组（132.54±43.20）pmol/L和C组（152.97±42.78）pmol/L]均显著高于A组（118.96±34.98）pmol/L,且C组与B组比较显著升高;SOD水平在B组（48.13±27.43）U/ml较A组（64.51±24.26）U/ml显著下降,随着BNP进一步升高SOD水平[C组（74.69±25.74）U/ml]显著高于B组,而C组与A组比较差异无显著性（P〉0.05）;MDA水平3组间比较差异无显著性（P〉0.05）;相关分析显示血清AOPP和MDA与BNP均呈显著正相关,SOD与BNP呈显著负相关。结论腹膜透析患者容量超负荷与氧化应激密切相关,两者可能共同参与心血管事件的发生。Objective To explore the relationship between serum B-type natriuretic peptide （BNP） lev- el and oxidative stress in patients on peritoneal dialysis. Methods A total of 81 patients on continuous am- bulatory peritoneal dialysis （CAPD） patients and 12 healthy controls were enrolled in this study. Serum BNP and oxidative stress biomarkers including advanced oxidation protein product （AOPP）, superoxide dismutase （SOD）, maleic dialdehyde （MDA） were measured. Patients were divided by BNP level into 3 groups： group A （BNP〈 128.63 pg/ml）, group B （BNP 128.634211.65 pg/ml）, and group C （BNP ~211.65 pg/ml）. The rela- tionship between serum BNP and oxidative stress and clinical indicators were explored. Results Serum BNP, AOPP and MDA levels were significantly higher in peritoneal dialysis patients than in healthy controls, but serum SOD level was significantly lower in peritoneal dialysis patients than in healthy controls. Serum AOPP was significantly higher in groups B and C than in group A, and was significantly higher in group C than in group B. Serum SOD was significantly lower in group B than in group A, was significantly higher in group C than in group B, and had no statistical difference between group A and group C （P〉0.05）. Serum MDA was statistically indifferent among the three groups （P〉0.05）. AOPP and MDA were positively correlat- ed with BNP, but SOD was negatively correlated with BNP in CAPD patients. Conclusions Volume over- load was closely related to the oxidative stress in patients on peritoneal dialysis, and the two related factors may contribute to the occurrence of cardiovascular events.

关 键 词：持续性非卧床腹膜透析 脑钠肽 晚期氧化蛋白产物 丙二醛 超氧化物歧化酶 

分 类 号：R459.5[医药卫生—治疗学]