黄嘌呤氧化还原酶与慢性肾脏病患者肾损害的关系研究

Relationship between xanthine oxidoreductase and renal damage in chronic kidney disease patients

目的探究慢性肾脏病(chronic kidney disease,CKD)患者血浆黄嘌呤氧化还原酶(xanthine oxidoreductase,XOR)活性与肾损害的关系。方法选取105例CKD患者作为研究对象,检测患者血浆XOR、黄嘌呤氧化酶(xanthine oxidase,XO)活性,计算XO/XOR比值,收集患者性别、年龄、舒张压(DBP)、空腹血糖(fasting blood glucose,FBG)、谷氨酰转肽酶(glutamyl transpeptidase,GGT)、总胆红素(total bilirubin,TBil)、尿酸(uric acid,UA)、三酰甘油(triglyceride,TG)、估算肾小球滤过率(estimated glomerular filtration rate,eGFR)、血钾、血钙、血磷、血氯等临床资料,采用相关分析探讨XOR、XO、XO/XOR比值与CKD患者临床资料间的相关性,采用多元线性逐步回归分析探讨XOR、XO、XO/XOR比值的影响因素。结果患者血浆XOR活性与eGFR、DBP、FBG、GGT呈正相关,与年龄、血氯呈负相关(均P<0.05);血浆XO活性与FBG、GGT、TBil、TG呈正相关,与血氯呈负相关(均P<0.05);XO/XOR比值与年龄、BUN呈正相关,与eGFR呈负相关(均P<0.05)。多元线性逐步回归模型结果显示eGFR、FBG、DBP为XOR的独立影响因素(P<0.05),FBG、GGT为血浆XO活性独立影响因素(P<0.05),eGFR为血浆XO/XOR比值的独立影响因素(P<0.05)。结论控制CKD患者FBG、DBP水平有利于降低CKD患者血浆XOR活性,研究出一种抑制XOR活性的而不影响UA生成药物可能成为延缓CKD病程的新的治疗方法。

Objective To explore the relationship between xanthine oxidoreductase(XOR)activity and kidney injury in patients with chronic kidney disease(CKD).Methods A total of 105 patients with CKD were selected as the research objects in this study.We measured plasma XOR and xanthine oxidase(XO)activities,and calculated the ratio of XO/XOR.Those patients’clinical data were collected,including sex,age,diastolic blood pressure(DBP),fasting blood glucose(FBG),triglyceride(TG),estimated glomerular filtration rate(eGFR),serum potassium,serum calcium,serum phosphorus,and blood chlorine.We used correlation analysis to analyze the relationship between the XOR,XO,XO/XOR ratio and clinical data of CKD patients.Multivariate linear regression analysis was used to explore the influencing factors of XOR,XO,XO/XOR ratio.Results Plasma XOR activity was positively correlated with eGFR,DBP,FBG,GGT,and negatively correlated with age,Cl-(P<0.05).Plasma XO activity was positively related to FBG,GGT,TBil,TG,and negatively correlated with Cl-(P<0.05).XO/XOR ratio was positively correlated with age,BUN,and negatively correlated with eGFR(P<0.05).Multiple linear regression analysis showed that eGFR,FBG and DBP were independent factors significantly associated with XOR(P<0.05),FBG and GGT were independent influencing factors of plasma XO activity(P<0.05),and eGFR was independent Influencing factors of plasma XO/XOR ratio(P<0.05).Conclusions Controlling the levels of FBG and DBP in CKD patients is beneficial to reduce the plasma XOR activity in CKD patients.So,developing a new drug to inhibit XOR activity without affecting UA production may provide a new therapy to delay the CKD progression.