降尿酸治疗对血液透析患者氧化应激状态改善作用的探讨

Investigation of Urate-lowering Therapy Effect on Blood Oxidative Stress in Hemodialysis Patients

目的:观察降尿酸治疗对血液透析(HD)患者氧化应激状态的改善作用。方法:选取51例血尿酸(SUA)>480μmol/L的HD患者作为研究对象,平均年龄(51.3±4.9)岁,平均透析年限(3.7±0.8)年,平均周透析时间(11.6±0.9)h。收集治疗前后血标本,检测SUA及氧化应激标志物8-羟基脱氧鸟苷(8-OHd G)和3-硝基酪氨酸修饰蛋白(3-NT)。结果:给予降尿酸治疗后,治疗后患者的SUA值比基线水平(512.4±109.8)μmol/L均显著降低(P<0.01),氧化应激标志物8-Ohd G为(0.97±0.43)ng/ml,较基线水平(1.93±0.94)ng/ml显著降低(P<0.01),与SUA水平呈正相关,相关系数r为0.608,P<0.01,而3-NT则无显著性差异[(32.46±9.95)n M vs(29.23±9.63)n M,P=0.104]。结论:降尿酸治疗可改善血液透析患者的氧化应激状态,值得临床推广应用。

Objective：To investigate the improvement effect of urate-lowering therapy on blood oxidative stress in hemodialysis（HD） patients. Method：51 HD patients who had serum uric acid （SUA） levels above 480μmol/L in our hospital were selected as research objects,the mean age was （51.3±4.9）years,the mean HD duration was （3.7±0.8）years,the mean dialysis time per week was （11.6±0.9）hours.Blood samples were collected for detecting SUA and oxidative stress markers（8-OhdG and 3-NT） before and after the treatment.Result：After urate-lowering therapy,the level of SUA in HD patients decreased significantly（P〈0.01）,comparing with the baseline level （512.4±109.8）μmol/L.The oxidative stress markers 8-hydroxy deoxyguanosine （8-OhdG ） also decreased significantly,comparing with the baseline level [（1.93±0.94）ng/ml vs （0.97±0.43）ng/ml,P〈0.01],which were positively correlated with the level of SUA,the correlation coefficient was 0.608,P〈0.01.However,the 3-nitrotyrosine modified protein （3-NT） was not significantly different from its baseline level [（32.46±9.95）nM vs （29.23±9.63）nM,P=0.104].Conclusion：Urate-lowering therapy can ameliorate the oxidative stress status in HD patients,is worthy of clinical application.