脂质过氧化与肾脏病变及纤维化关系探讨

Discussion on the Relationship between Lipid Peroridation and Renal Pathology Manifestation as well as Renal Fibrosis

目的 研究肾小球肾炎患者脂质过氧化与其病理改变及肾脏纤维化之间的关系。方法 肾小球肾炎患者50例,27例正常人群作为对照,分别检测肾炎组及对照组的血清丙二醛(MDA)、超氧化物歧化酶(SOD)、维生素E(VitE)、血清层粘蛋白、透明质酸、前胶原Ⅲ、胶原Ⅳ。共有31例患者进行了肾脏穿刺活检术。结果 肾炎组的SOD和VitE明显低于对照组,而MDA则高于对照组。31例进行肾活检的患者,按病理改变的严重程度分为轻、中、重三组,比较其MDA、SOD、VitE水平,结果显示各组间有显著差异。根据血中胶原蛋白含量将20例肾炎患者分为正常与非正常两组,发现两者的MDA、SOD、VitE有显著差异。结论 肾小球肾炎患者的抗氧化能力下降以及与之相关的脂质过氧化在较早期就会导致肾脏损害。脂质过氧化的程度与肾脏病理表现严重程度之间有密切关系,并有可能在肾脏纤维化中起一定作用。

Objective To explore the relationship between the lipid peroxidation and renal pathology manifestation as well as renal fibrosis. Methods Malondialdehyde (MDA), Superoxide dismutase (SOD) and vitamin E (VitE) was detected in 50 glomerulonephritis patients and 27 normal controls with the method of chromometry. Serum level of laminin, hyaluronic acid, procollagen Ⅲ and collagen Ⅳ of 20 patients were also detected. Renal biopsy was carried out in 31 glomerulonephritis patients. Results The SOD and Vit E of serum in glomerulonephritis patients were lower than those in the control group (p < 0.001). There was a significant difference of MDA, SOD and Vit E among three groups that were divided according to renal pathological extent in 31 patients who underwent renal biopsy. There was significant difference of MDA, SOD and VitE between the two groups which were divide according to the concentrations of laminin, hyaluronic acid, procollagen Ⅲ and collagen Ⅳ in 20 patients. Conclusions The decline of antioxidant ability and the related lipid peroxidation is identified in patients with glomerulonephritis, which may induce renal impairment in early stages. Lipid peroxidation in glomerulonephritis is related to the renal pathological manifestation as well as renal fibrosis.