尿RNA氧化产物水平预测胸外科手术患者术后急性肾损伤的价值  

Urinary RNA oxidation as a potential predictive biomarker for postoperative acute kidney injury in thoracic surgery patients

作　　者：徐冷楠[1] 赵班[1] 翁卿华 陈爱群[1] 孙颖[1] 蔡剑平[3] 毛永辉[1] Xu Lengnan;Zhao Ban;Weng Qinghua;Chen Aiqun;Sun Ying;Cai Jianping;Mao Yonghui(Department of Nephrology,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;Pharmacy Department,the Third Affiliated Hospital of Shanghai University(Wenzhou People's Hospital),Wenzhou 325000,China;The NHC Key Laboratory of Geriatrics,Beijing Hospital,National Center of Gerontology,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院肾内科,国家老年医学中心,中国医学科学院老年医学研究院,北京100730 [2]上海大学第三附属医院,温州市人民医院药剂科,温州325000 [3]北京医院老年病研究所,国家老年医学中心,中国医学科学院老年医学研究院,北京100730

出　　处：《中华肾脏病杂志》2024年第10期811-814,共4页Chinese Journal of Nephrology

基　　金：北京市自然科学基金(7222159);中央高水平医院临床科研基金项目(BJ-2022-105、BJ-2022-129)。

摘　　要：氧化应激在急性肾损伤(acute kidney injury,AKI)中扮演了一个关键角色。8⁃氧化⁃7,8⁃二氢鸟苷(8⁃oxo⁃7,8⁃dihydroguanosine,8⁃oxo⁃Gsn)可反映机体整体的氧化应激水平。该研究检测了62例接受胸腔镜手术(胸腔镜组)或开胸手术(开胸组)患者围手术期尿8⁃oxo⁃Gsn水平和肾功能相关指标,结果显示,术后24 h尿8⁃oxo⁃Gsn升高,术后48 h随病情改善而下降。10例有严重并发症的患者尿8⁃oxo⁃Gsn持续升高。胸腔镜组患者尿8⁃oxo⁃Gsn水平较开胸组恢复较快。尿8⁃oxo⁃Gsn水平与胸外科术后肾损伤之间存在一定的相关性,提示RNA氧化应激可能在手术相关AKI的发病机制中扮演了重要角色。Oxidative stress plays a key role in acute kidney injury(AKI).8-Oxo-7,8-dihydroguanosine(8-oxo-Gsn)can reflect the overall level of oxidative stress in the body.The levels of urinary 8-oxo-Gsn and renal function-related indicators in 62 patients who underwent video-assisted thoracic surgery(VATS)or open-chest surgery were measured during the perioperative period.The results showed that urinary 8-oxo-Gsn increased 24 hours after surgery and decreased 48 hours after surgery as the condition improved.In 10 patients with severe complications,urinary 8-oxo-Gsn continued to rise.The level of urinary 8-oxo-Gsn in the VATS group recovered faster than that in the open-chest surgery group(P<0.05).There was a certain correlation between the level of urinary 8-oxo-Gsn and postoperative renal injury in thoracic surgery,suggesting that RNA oxidative stress may play an important role in the pathogenesis of surgery-related AKI.

关 键 词：氧化性应激 急性肾损伤 围手术期 8⁃羟基⁃2'⁃脱氧鸟苷 手术后并发症 

分 类 号：R692[医药卫生—泌尿科学] R655[医药卫生—外科学]