儿童肾病活动期氧化应激状态变化及临床意义

The Oxidative Stress State and Clinical Significance on the Active Stage of Children with Kindey Disease

目的探讨儿童肾病综合征和过敏性紫癜肾炎疾病活动与氧化应激状态的关系及其临床意义。方法抽取诊断明确的肾病综合征和过敏性紫癜肾炎患儿疾病活动期清晨空腹外周血,采用化学比色法检测血中丙二醛(Malondialdehyde,MDA)含量及超氧化物歧化酶(Superoxide dismutase,SOD)和总抗氧化能力(Total antioxidative capacity,T-AOC)的活性。结果肾病综合征患儿疾病活动期血中MDA含量明显高于正常对照组(P=0.011);血中SOD、T-AOC活性明显低于正常对照组(P=0.000);且肾病综合征活动期MDA含量与血清白蛋白含量及24h尿蛋白排泄量分别呈负相关及正相关(r分别为-0.557,0.793,P分别为0.048,0.002),SOD活性和T-AOC活性与24h尿蛋白排泄量呈负相关(r分别为-0.822,-0.851;P分别为0.001,0.000)。紫癜性肾炎患儿疾病活动期血中MDA含量明显高于正常对照组(P=0.014),血中SOD、T-AOC活性明显低于正常对照组(P<0.05)。结论儿童肾病综合征和过敏性紫癜肾炎疾病活动期存在明显的过氧化反应增强及抗氧化能力减退,且与肾病轻重密切相关。

Objective To investigate the relationship and clinical significance between the activity of children with nephrotic syndrome（NS） or Henoch-Sch？nlein purpura nephritis （HSPN） and oxidative stress state. MethodsTo collect peripheral blood in the morning on the active stage of children with NS or HSPN. The level of serum malondialdehyde （MDA）,superoxide dismutase （SOD） and total antioxidative capacity （T-AOC） were measured. Results Active-stage NS had significantly higher serum MDA levels（P=0.011） and lower serum SOD （P=0.00）,and serum T-AOC （P=0. 00）activities compared with the control groups. There were significant negative correlation between the level of serum MDA and seralbumin （r=-0. 557,P=0.048）, significant positive correlation between the level of serum MDA and the level of 24h urine protein excretion （r=0.793,P=0.002）;and significant negative Correlation between the level of antioxidative enzymes （serum SOD and serum T-AOC）activities and 24h urine protein excretion （r=-0.822,P=0.001 and r=-0.851,P=0.000,respectively ）. Active-stage HSPN also had significantly higher serum MDA levels （P=0.014） and lower serum SOD （P=0.008）,and serum T-AOC （P=0.003） activities compared with the control groups. Conclusions There existing increased peroxidatic reaction and decreased antioxygen capability on the active stage of children with NS or HSPN,and significant correlation between it and the damage degree of pathogenetic condition.