超氧化物歧化酶对高血压合并高同型半胱氨酸血症患者早期肾损害的影响  

Effect of superoxide dismutase on early kidney damage in hypertensive patients with hyperhomocysteinemia

作　　者：林林 贠琳[2] 徐瑞[1] Lin Lin;Yun Lin;Xu Rui(Department of Cardiology,the First Affiliated Hospital of Shandong First Medical University&Shandong Provincial Qianfoshan Hospital,Jinan 250014,China;不详)

机构地区：[1]山东第一医科大学第一附属医院(山东省千佛山医院)心内科,济南250014 [2]济南市妇幼保健院内科

出　　处：《临床内科杂志》2021年第10期674-677,共4页Journal of Clinical Internal Medicine

基　　金：山东省自然科学基金资助项目(ZR2014HP046);山东省重点研发计划项目(2018GSF118009);山东省医药卫生科技发展计划项目(2017WS462);济南市科技计划项目(201805060)。

摘　　要：目的探讨超氧化物歧化酶(SOD)与高血压合并高同型半胱氨酸血症(HHcy)患者早期肾损害的关系。方法选取原发性高血压患者987例,根据同型半胱氨酸(Hcy)水平将其分为普通高血压组(659例,Hcy<15μmol/L)和高血压合并HHcy组(328例,Hcy≥15μmol/L);再根据尿微量白蛋白/肌酐比值(UACR)将987例患者分为高血压不伴肾损害组(750例,UACR<30 mg/g)和高血压合并早期肾损害组(237例,30 mg/g≤UACR<300 mg/g)。根据UACR将高血压合并HHcy组328例患者分为肾损害组(106例)和无肾损害组(222例)。收集所有患者的临床资料并按以上分组进行比较。采用Spearman或Pearson相关分析探讨高血压患者UACR与Hcy、SOD的相关性。采用二元logistic回归分析探讨高血压早期肾损害的影响因素。结果高血压合并HHcy组年龄、高血压病程、吸烟及饮酒患者比例、Hcy、尿酸(UA)、血肌酐(SCr)、血尿素氮(BUN)、UACR、胱抑素C(CysC)、尿α1微球白蛋白水平均高于普通高血压组,而SOD、总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、估算的肾小球滤过率(eGFR)均低于普通高血压组(P<0.05)。高血压合并早期肾损害组年龄、糖尿病病史患者比例、高血压病程、心率、Hcy、空腹血糖(FPG)、糖化血红蛋白、SCr、BUN、CysC、UACR、尿α1微球白蛋白水平均高于高血压不伴肾损害组,而饮酒患者比例、舒张压、SOD、HDL-C、eGFR均低于高血压不伴肾损害组(P<0.05)。在高血压合并HHcy患者中,肾损害组SOD水平明显低于无肾损害组(P<0.001)。Spearman相关分析结果显示,UACR与SOD呈负相关,与Hcy呈正相关(P<0.001)。Pearson相关分析显示,Hcy与SOD呈负相关(P<0.001)。二元logistic回归分析结果显示,年龄、Hcy、收缩压、糖尿病病史、FPG为高血压早期肾损害的独立危险因素,而Hcy×SOD、HDL-C为独立保护因素(P<0.05)。结论SOD可能降低Hcy给高血压合并HHcy患者带来的肾损害,为后续研究SOD保护作用提�Objective To investigate the relationship between superoxide dismutase(SOD)and early renal damage of hypertensive patients with hyperhomocysteinemia(HHcy).Methods A total of 987 patients with essential hypertension were enrolled.According to the hyperhomocysteinemia(Hcy)level,they were divided into general hypertension group(659 cases,Hcy<15μmol/L)and hypertension combined with HHcy group(328 cases,Hcy≥15μmol/L).According to the urine microalbumin/urine creatinine ratio(UACR),the patients were divided into hypertension without early renal damage group(750 cases,UACR<30 mg/g)and hypertension with early renal damage group(237 cases,30 mg/g≤UACR<300 mg/g).According to the UACR,328 patients in hypertension combined with HHcy group were divided into renal damage group(106 cases)and no renal damage group(222 cases).The clinical data of all patients were collected and compared according to the above groups.Spearman or Pearson correlation analysis was used to explore the correlation between UACR,Hcy and SOD in patients with hypertension.Binary logistic regression analysis was used to explore the influencing factors of early renal damage in hypertension.Results The age,course of hypertension,proportion of smoking and drinking patients,Hcy,UA,SCr,BUN,UACR,CysC and urineα1 microglobulin levels in hypertension complicated with HHcy group were higher than those in ordinary hypertension group,while SCr,SOD,TC HDL-C and GFR were lower than those in ordinary hypertension group(P<0.05).The age,proportion of patients with diabetes history,course of hypertension,heart rate,Hcy,FPG,HbA1c,SCr,BUN,CysC,UACR and urineα1 microalbumin levels were all higher in hypertension with early renal damage group than those in hypertension without early renal damage group.However,the proportion of drinking patients,diastolic blood pressure,SOD,HDL-C and eGFR were lower than those in hypertension without early renal damage group(P<0.05).In hypertensive patients with HHcy,the level of SOD in renal damage group was significantly lower than tha

关 键 词：超氧化物歧化酶 同型半胱氨酸 高血压 肾损害 氧化应激 

分 类 号：R544.1[医药卫生—心血管疾病]