血硒与原发性肾小球疾病氧化损伤的关系

目的: 观察原发性肾小球疾病(PGS)患者血浆硒(Se)、谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)和丙二醛(MDA)含量的变化及相互关系,探讨血硒对PGS氧化损伤作用的影响及其临床意义。方法: 运用催化极谱法和比色法分别对45例PGS患者和20例正常对照者的血浆Se、GSH-Px、SOD、MDA含量进行测定,同时对PGS患者进行肾功能检测。分析血Se与其他参数的关系以及肾功能与血Se和其他参数的相关性。结果: PGS肾功能正常组(I组)和肾功能异常组(Ⅱ组)血Se含量均明显低于正常对照组,Ⅱ组低于Ⅰ组,但差异无显著性;Ⅰ、Ⅱ组的血浆GSH-Px含量均明显低于正常对照组,MDA含量Ⅰ、Ⅱ组明显高于对照组,Ⅱ组血浆GSH-Px、SOD含量较Ⅰ组低、MDA含量较Ⅰ组更高,但差异也无显著性。直线回归和相关分析显示:疾病组(Ⅰ、Ⅱ两组合并)血Se含量与血GSH-Px、SOD呈显著正相关,与MDA呈显著负相关;血肌酐浓度与血Se、GSH-Px、SOD呈显著负相关,而与MDA呈显著正相关。结论: 低血硒通过削弱机体的抗氧化能力,使活性氧及其介导的脂质过氧化反应增强,从而导致或加重PGS。

RELATION OF PLASMA SELENIUM TO OXIDATIVE STRESS IN PATIENTS WITH PRIMARY GLOMERULAR DISEASES

Objective: To study the relation of plasma Se to oxidative stress in the patients with primary glomerular diseases (PGS) and its clinical significance. Methods: Plasma Se concentration ,GSH-Px and SOD activities and contents of MDA in 45 patients with PGS and 20 normal control (NC)were measured by catalytic polarography and colorimetric assay. Serum creatinine, urea nitrogen and uric acid concentrations in these patients were determined simultaneously. Results: 1. Plasma Se contents of both PGS patients of normal(groupⅠ) and impaired renal function (groupⅡ) were significantly lower than those in NC;2. PGS patients of groupⅠandⅡhad significantly lower plasma GSH-Px and SOD activities than NC and their MDA contents were siginificantly higher. 3. Plasma GSH-Px and SOD activities and MDA contents between groupⅠand Ⅱ were not different; 4. Multiple logistic regression analysis showed that plasma Se content in patients with PGS was positively related to plasma GSH-Px , SOD activities and negatively correlated with MDA. Serum creatinine concentrations were negatively correlated significantly with plasma Se, GSH-Px, SOD and positively related to MDA. Conclusion: Plasma Se deficiency may be an important non-immune factor resulting in or worsening PGS through weakening body抯 antioxidative defence. It is suggested that sufficient Se supplementation in practice may be obviously beneficial to oxidative stress in the patients with PGS.