摘要
目的探讨影响慢性肾脏病(chronic kidney disease,CKD)进展的因素,为综合干预治疗提供依据。方法 CKD患者279例,分为CKD-1、CKD-2、CKD-3a、CKD-3b、CKD-4期组以及CKD-5期非透析组、CKD-5期腹膜透析(peritoneal dialysis,PD)组和CKD-5期血液透析(hemodialysis,HD)组,同期体检健康者23例为对照组,测定不同CKD分期患者血清同型半胱氨酸(homocysteine,Hcy)、游离脂肪酸(free fatty acid,FAA)、超氧化物歧化酶(superoxide dismutase,SOD)变化,并与对照组进行比较。结果 (1)CKD-2、CKD-3a、CKD-3b、CKD-4期以及CKD-5期非透析组、CKD-5期PD组和CKD-5期HD组Hcy[12.70(10.40,15.40)、15.80(14.10,19.00)、20.05(18.08,24.85)、22.10(17.40,30.30)、27.70(19.30,42.30)、23.00(16.98,28.78)、29.45(18.38,53.13)μmol/L]均高于对照组[(10.60(9.30,11.70)μmol/L)](P<0.01);(2)CKD各期FFA与对照组比较差异无统计学意义(P>0.05);CKD-1、CKD-3a、CKD-4以及CKD-5期非透析组FFA阳性率(25.00%、20.59%、20.00%、23.53%)高于对照组(0)(P<0.05);(3)CKD-1、CKD-2、CKD-3a、CKD-3b和CKD-4期组,CKD-5期非透析组,CKD-5期PD组和CKD-5期HD组SOD值分别为138.05(102.58,153.33)、122.40(96.80,141.60)、134.00(109.05,144.20)、113.35(97.45,127.18)、98.00(84.30,108.50)、85.90(71.55,95.20)、87.95(75.50,107.70)、103.55(85.23,124.00)u/mL,CKD各期SOD均低于对照组[144.20(141.70,151.60)u/mL],差异有统计学意义(P<0.01);CKD-1、CKD-2、CKD-3a、CKD-3b期SOD值比较差异无统计学意义(P>0.05);与CKD-3b期比较,CKD-4及CKD-5期非透析组和PD组SOD均降低(P<0.01);CKD-5期HD组SOD值高于CKD-5期非透析组和PD组,差异有统计学意义(P<0.01)。结论随着CKD的进展,患者Hcy升高、SOD降低,且同时存在FFA阳性率升高,建议自CKD-3期应注重抗氧化应激治疗。
Objective To investigate the factors influencing comprehensive intervention. Methods A total of 279 patients chronic kidney disease （CKD） to provide a basis for a with CKD were divided into CKD-1, 2, -3a, -3b and -4 groups, CKD-5 non-dialysis group, CKD-5 peritoneal dialysis （PD） group and CKD-5 hemodialysis （HD） group, and another 23 healthy volunteers were as controls （control group）. The levels of homocysteine （Hcy）, free fatty acid （FFA） and superoxide dismutase （SOD） were observed in CKD patients in different stages and compared with control group. Results The Hcy level was significantly higher in CKD-2, CKD-3a, CKD-3b and CKD-4 groups, CKD-5 non-dialysis group, CKD-5 PD group and CKD-5 HD group （12. 70（10.40,15.40）, 15.80（14. 10,19.00）, 20.05（18.08,24. 85）, 22.10（17.40,30.30）, 27.70（19.30,42.30）, 23.00（16.98,28.78）, 29.45（18.38,53.13） μmol/L） than that in control group （10.60 μmol/L）, respectively （P〈0.01）. There was no significant difference in FFA between CKD patients and control group （P〉0. 05）. The positive rate of FFA was 25.00%, 20. 59%, 20.00% and 23.53% in CKD-1, CKD-3a and CKD-4 groups and CKD-5 non-dialysis groups respectively, significantly higher than that in control group （0）,respectively（P〈0.05）. SOD level was 138.05（102.58,153.33）, 122.40（96.80,141.60）, 134.00（109.05,144.20）, 113.35（97. 45, 127. 18）, 98. 00 （84. 30, 108. 50）, 85. 90 （71. 55, 95. 20）, 87. 95 （75. 50, 107. 70） and 103.55（85.23,124.00） u/mL in CKD-1, CKD-2, CKD-3a, CKD-3b and CKD-4 groups, CKD-5 non-dialysis group, CKD-5 PD group and CKD-5 HD group, significantly lower than that in control group （144. 20 （141. 70, 151. 60） u/mL）, respectively （P〈0.01）. There were no significant differences in SOD level among CKD-1, CKD-2, CKD-3a and CKD-3b groups （P〉0.05）. SOD level was lower in CKD-4 group, CKD-5 non-dialysis group and CKD-5 PD group than that in CKD-3b group （P〈0.01）. SOD level was h
出处
《中华实用诊断与治疗杂志》
2015年第12期1204-1206,共3页
Journal of Chinese Practical Diagnosis and Therapy
