论文部分内容阅读
目的探讨不同分期CKD患者血红素氧合酶-1(HO-1)与氧化应激的变化和它们之间的相关性及影响因素。方法选择CKD患者132例(CKD组)及健康体检者30例(对照组),测定血清HO-1、丙二醛(MDA)及过氧化物歧化酶(SOD)。结果 (1)CKD组HO-1、MDA高于对照组,SOD低于对照组,差异有统计学意义(P<0.05)。HO-1、MDA呈上升趋势,至CKD4期达高峰。SOD呈下降趋势。(2)单因素相关分析:HO-1与MDA、血尿酸(UA)、甲状旁腺素呈正相关,与SOD、肾小球滤过率(e GFR)、血清铁(SI)、铁饱和度(ISAT)、血清总胆红素(TBIL)呈负相关。MDA与UA、PTH呈正相关,与SOD、e GFR、SI、ISAT呈负相关。SOD与e GFR、总蛋白(TP)、白蛋白(Alb)、SI、血清钙(Ca)、TBIL呈正相关,与UA、24 h尿蛋白定量、PTH呈负相关。(3)多因素回归分析提示,e GFR、MDA、SI是血清HO-1的独立影响因素;血清HO-1、SOD、PTH是MDA的独立影响因素;Alb、MDA、e GFR是SOD的独立影响因素。结论 CKD患者普遍存在氧化应激,低蛋白血症、高甲状旁腺素血症是氧化应激的独立影响因素。肾功能减退、MDA、铁缺乏是HO-1的独立影响因素。
Objective To investigate the changes of heme oxygenase-1 (HO-1) and oxidative stress in CKD patients with different stages and their correlations and their influencing factors. Methods Serum levels of HO-1, malondialdehyde (MDA) and superoxide dismutase (SOD) were measured in 132 CKD patients and 30 healthy controls. Results (1) The levels of HO-1 and MDA in CKD group were higher than those in control group and SOD was lower than that in control group (P <0.05). HO-1, MDA showed an upward trend, reaching the peak of CKD4. SOD showed a downward trend. (2) Univariate correlation analysis showed that there was a positive correlation between HO-1 and MDA, UA and parathyroid hormone, and the correlation between HO-1 and SOD, glomerular filtration rate (GFR), serum iron (ISAT), serum total bilirubin (TBIL) was negatively correlated. MDA and UA, PTH was positively correlated with SOD, e GFR, SI, ISAT was negatively correlated. SOD and eGFR, total protein (TP), albumin (Alb), SI, serum calcium (Ca), TBIL were positively correlated with the UA, 24 h urinary protein, PTH was negatively correlated. (3) Multivariate regression analysis showed that e GFR, MDA and SI were the independent influential factors of serum HO-1. Serum HO-1, SOD and PTH were independent factors of MDA. Alb, MDA and e GFR were independent of SOD Influencing factors. Conclusion The prevalence of oxidative stress, hypoproteinemia and hyperparathyroidism in CKD patients is an independent factor of oxidative stress. Renal dysfunction, MDA, iron deficiency are independent factors of HO-1.