慢性肾功能衰竭患者脂质过氧化物、超氧化物歧化酶及免疫功能状态的临床研究

Clinical study on relationship of chronic renal failure patients with serum lipid peroxide,superoxide dismutase and immunity in patients with chronic renal failure

目的：研究慢性肾功能衰竭（肾衰）患者氧自由基代谢和免疫功能状态的变化以及两者的关系。方法：测定８０例慢性肾衰患者和３０例正常人血清脂质过氧化物（ＬＰＯ）、超氧化物歧化酶（ＳＯＤ）、可溶性白细胞介素２受体（ＳＩＬ２Ｒ）和外周血Ｔ淋巴细胞亚群的水平并进行比较。结果：慢性肾衰患者血清ＬＰＯ、ＳＯＤ和ＳＩＬ２Ｒ水平较正常人明显升高（Ｐ均＜０．０１），外周血Ｔ淋巴细胞亚群ＣＤ＋３、ＣＤ＋４、ＣＤ＋８细胞及ＣＤ＋４／ＣＤ＋８比值则显著降低（Ｐ＜０．０５或Ｐ＜０．０１）。血清ＳＯＤ及ＳＩＬ２Ｒ水平与血肌酐（ＳＣｒ）呈显著正相关，与肾小球滤过率（ＧＦＲ）呈显著负相关；血清总ＳＯＤ、ＣｕＺｎＳＯＤ活性与ＳＩＬ２Ｒ水平呈显著正相关。结论：慢性肾衰患者存在氧自由基的蓄积，脂质过氧化反应的病理性亢进和超氧化物歧化酶代偿性增高及免疫功能异常的病理改变；血清ＳＯＤ、ＳＩＬ２Ｒ水平可作为肾功能损害的客观指标。

Objective:To investigate changes in oxygen free radicals (OFR) metabolism and cellmediated immunity and their clinical significance in patients with chronic renal failure (CRF).Methods:Concentrations of serum lipid peroxide (LPO),soluble interleukin2 receptor (SIL2R) and the activities of serum total superoxide dismutase (TSOD),including CuZnSOD and MnSOD,as well as Tlymphocyte subpopulations were measured in 80 cases of CRF patients and 30 healthy controls. Results :The levels of LPO,SOD and SIL2R were significantly increased,whereas Tlymphocyte subpopulations (CD + 3,CD + 4,CD + 8 cells) and the ratio of CD + 4/CD + 8 were markedly decreased in CRF patients compared to normal controls ( P <0 05 or P <0 01).Meanwhile,serum creatinine concentration was positively correlated to both SOD activity and SIL2R,but glomerular filtration rate was negatively correlated to SOD activity and SIL2R.In addition,SIL2R was positively correlated to TSOD and CuZnSOD activities.Conclusions:These results indicate that overproduction of OFR and abnormality of immunity exist in CRF patients.Serum SOD and SIL2R may be useful parameters to reflect the degree of renal damage.