慢性肾功能衰竭患者血清对氧磷酶1水平与心脏结构改变的相关性研究

Correlation of serum paraoxonase 1 level with cardiac structure in patients with chronic renal failure

摘要:

目的 探讨慢性肾功能衰竭（CRF）患者血清对氧磷酶1（PON1）水平与心脏结构改变的相关性。方法 连续性收录2013年1月至2015年4月于解放军总医院第一附属医院住院治疗的80例CRF患者作为CRF组，40例无肾脏疾病的体检患者作为对照组。比较分析血清PON1等氧化应激指标的改变，以及和心脏结构的相关性。结果 慢性肾脏病（CKD）5期患者左室舒张末期内径（LVDd）、左室质量（LVM）和左室质量指数（LVMI）水平明显高于对照组（P＜0.05）。CKD5期患者总抗氧化态（TAS）明显低于对照组（P＜0.05），氧化应激指数（OSI）水平明显高于对照组（P＜0.05）。CKD患者血清PON1水平与LVM（r＝-0.641，P＝0.033）和LVMI（r＝-0.562，P＝0.029）呈负相关。血清PON1水平作为自变量能分别进入LVM（P＝0.013）和LVMI（P＝0.037）为因变量的线性回归模型方程。结论 CRF患者体内PON1水平明显下降，可以作为一个独立的危险因素对心室结构产生影响。

Abstract:

Objective To investigate the correlation of serum level of paraoxonase 1 (PON1) with alterations of cardiac structure in the patients with chronic renal failure (CRF). Methods Eighty CRF patients admitted in our hospital from January 2013 to April 2015 were recruited in this study, and 40 individuals without any renal diseases who took physical examination during the same period served as controls. The serum PON1 level, total oxidation state (TOS), total anti-oxidation state (TAS) and oxidative stress index were measured and analyzed. Echocardiography was carried out to evaluate the heart structure. Results Left ventricular end diastolic diameter (LVDd), left ventricular mass (LVM) and left ventricular mass index(LVMI) were significantly larger in CRF patients at stage 5 chronic kidney disease (CKD) than in controls (P＜0.05). TAS was significantly lower, while oxidative stress index (OSI) higher in CRF patients at stage 5 CKD than in controls (P＜0.05). The serum level of PON1 was negatively correlated with LVM (r＝-0.641, P＝0.033) and LVMI (r＝-0.562, P＝0.029), and as an independent variable, it could enter the linear regression model with LVM (P＝0.013) and LVMI (P＝0.037) as dependent variables, respectively. Conclusion The serum level of PON1 is significantly decreased in CRF patients, and can be regarded as an independent risk factor for cardiac structure.