慢性肾脏病不同临床分期患者氧化应激水平的比较研究

目的观察和比较慢性肾脏病（CKD）不同临床分期患者的氧化应激状态。方法选取163例CKD患者作为研究对象,根据估算的肾小球滤过率（eGFR）分为CKD15期组,其中CKD5期组根据患者是否接受血液透析治疗进一步分为透析组（CKD5期-透析组）和非透析组（CKD5期-非透析组）。检测各组患者血清丙二醛（MDA）水平和血清超氧化物歧化酶（SOD）活性,进行统计学分析和比较。结果血清MDA水平和SOD活性与eGFR呈线性相关（R2=0.547,R2=0.406;P〈0.05）。各组血清MDA水平为CKD4期组〉CKD3期组〉CKD2期组（P〈0.05）,血清SOD活性为CKD4期组〈CKD3期组〈CKD2期组（P〈0.05）;两项指标在CKD4期组与CKD5期组以及CKD2与CKD1组组间比较差异均无统计学意义（P〉0.05）。CKD5期-透析组和CKD5期-非透析组患者血清MDA水平分别为（9.20±1.75）nmol/mL和（7.01±1.40）nmol/mL,血清SOD活性分别为（59.24±17.82）U/mL和（72.21±17.82）U/mL,组间比较差异均有统计学意义（P〈0.05）。结论 CKD患者氧化应激状态随着肾功能的减退而逐渐加剧。与未经血液透析治疗的CKD5期患者比较,接受血液透析治疗者的氧化应激状态较为严重。

Oxidative stress in patients with chronic kidney diseases of different clinical stages

Objective To observe and compare the oxidative stress in patients with chronic kidney diseases (CKD) of different clinical stages. Methods One hundred and sixty-three patients with CKD were enrolled, and CKD1 to CKD5 groups were divided according to estimated glomerular filtration rate (eGFR). Besides, patients in CKD5 group were subdivided into CKD5-hemodialysis group and CKD5-non-hemodialysis group according to dialysis management. Serum malonaldehyde (MDA) level and superoxide dismutase (SOD) activity were detected in each group, and statistical analysis was conducted. Results Serum MDA level and SOD activity had linear correlation with eGFR （R2=0.547，R2=0.406；P<0.05）. For CKD2 group, CKD3 group and CKD4 group, serum MDA level was highest in CKD4 group and lowest in CKD2 group （P<0.05）, and SOD activity was lowest in CKD4 group and highest in CKD2 group (P<0.05）. However, there was no significant difference in these two parameters between CKD4 group and CKD5 group and between CKD2 group and CKD1 group （P>0.05）. There were significant differences in serum MDA levels and SOD activity between CKD5-hemodialysis group and CKD5-non-hemodialysis group （9.20±1.75）nmol/mL vs (7.01±1.40) nmol/mL and （59.24±17.82）U/mL vs （72.21±17.82）U/mL, respectively （P<0.05）]. Conclusion Oxidative stress increases with renal function decrease in patients with CKD. Compared with CKD5 patients without hemodialysis, those managed with hemodialysis have more severe oxidative stress.