严重哮喘患者氧化应激和抗氧化剂生物标志物检测及其临床意义

目的探讨严重哮喘患者氧化应激和抗氧化剂生物标志物水平，分析哮喘严重程度与氧化应激负荷和抗氧化剂水平间的关系。方法选择支气管哮喘患者120例，其中轻度哮喘组48例，重度哮喘组72例，另选择健康者45例为对照组。检测所有受试者血清维生素A、维生素E、Cu、Zn、Se、GSH、丙二醛、尿酸水平及总抗氧化能力（TAC），并分析这些参数的相关性，结果维生素A、维生素E、TAC、丙二醛、FeNO水平随着哮喘的严重程度逐渐上升（P〈0．05）。维生素E、GSH水平与维生素A水平呈正相关（r=0.37，0.28；P=0.00，0.02）。尿酸、丙二醛水平与维生素A水平负相关性（r=-0．34，-0.35；P=0.00，0.02）。GSH水平与维生素E水平呈正相关性（r=0.24，P=0.03），尿酸、丙二醛水平与维生素E水平呈负相关性（r=-0．36，-0.38；P=0.00，0．00）维生素E、尿酸水平与BMI呈正相关性（r=0.40，0.19；P=0.00，0.02）．GSH、TAC、丙二醛水平与BMI呈负相关性（r=-0.41，-0.36，-0.39；P=0.00，0．01，002）。BMI、Zn、Cu、Se、维生素A、维生素E、GSH、尿酸与TAC水平呈正相关（r=0.36，0.25，0.31，0.33，0.36，0.24，0.61，0.33；P=0．01，0.03，0.02，0.02，0.01，0.03，0.00，0.01），丙二醛水平与TAC水平呈负相关（r＝-0.71，P=0.00）。BMI、Cu、GSH、尿酸水平均与丙二醛水平呈负相关性（r=-0．39，-0.71，-0.75，0.37；P=0.02，0．00，0.00，0．00）。GSH、尿酸水平与FeNO水平呈负相关性（r=-0.77，-0.34；P=0.00，0.02）结论总体抗氧化剂水平与哮喘患者哮喘严重程度呈负相关，严重哮喘患者中无维生素或微量元素缺乏，重度哮喘中的氧化应激防御能力可能受到维生素或微量元素缺乏以外的因素的驱动。

Objective To study oxidative stress and antioxidant biomarkers in patients with severe asthma, and analyze the relationship hetween astbma severity and oxidative stress load and antioxidant levels. Methods A total of 120 patients with bronchial asthma were selected as subjects, 48 cases in mild asthma group, 72 cases in severe asthma group and 45 cases of＇healthy controls. The serum levels of vitamin A, vitamin E, Cu, Zn, Se, GSH, MI3A, uric acid and the total antioxidant capacity （ TAC ） were measured in all the subjects. The correlations of these parameters were analyzed. Results The levels of vitamin A, vitamin E, TAC, MDA and FeNO gradually increased with the severity of asthma （ P〈0.05 ） . Vitamin E and （;SH levels were positively correlated with vitamin A levels （ r=0.37, 0.28; P=0.00, 0.02 ） , Uric acid, lnalondialdehyde levels and vitamin A levels were negatively correlated （ r=-0.34, -0.35; P=0.00, 0.02 ） . The level of GSH was positively correlated with the level of vitamin E （ r=0.24, P=0.03 ） . The levels of uric acid and malondialdehyde were negatively correlated with the level of vitamin E （r=-0.36, -0.38; P=0.00, 0.00 ） . The levels or vitamin E and uric acid were positively correlated with BMI （ r=0.40, 0.19; P=0.00, 0.02 ） . The levels of＇ GSH, TAC and MI）A were negatively correlated with BMI （ r=-0.41, -0.36, -0.39; P=0.00, 0.01, 0.02 ） . The levels of BMI, Cu, GSH and uric acid were negatively correlated with malondialdehyde （ r=-0.39, -0.71, -0.75, -0.37; P=0.02, 0.00, 0.00, 0.00 ） . GSH and uric acid were negatively correlated with FeNO level （ r=-0.77, -0.34; P=0.00, 0.02 ） . Conclusion The total antioxidant levels are inversely related to the severity of asthma in asthmatics, with no vitamin or micronutrient deficiencies in severe asthma, and that oxidative stress defenses in severe asthma may be driven by factors other than vitamin or trace element deficiency.