摘要目的 观察青海省兴海县大骨节病(KBD)病区儿童血清中丙二醛(MDA)及抗氧化酶的变化,探讨体内氧自由基损伤与KBD的关系.方法 在青海省兴海县KBD病区唐乃亥乡小学、下鹿圈村小学以及曲什安乡小学选择7～ 12岁的KBD患儿64名作为KBD组,46名健康儿童作为内对照组,在非病区陕西省长安区南樊小学选择59名健康儿童作为外对照组.分别采集其枕部发样和清晨空腹外周血,采用单纯随机抽样方法在每组中各抽取20例发样及血样,应用2,3-二告氨基萘(DAN)荧光法测定发硒和血硒水平；通过生化方法检测样本血清中谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)活力,总抗氧化能力(T-AOC)及MDA水平.结果 KBD组发硒[(67.64±17.28)μg/L]、血硒[(36.27±13.29)μg/L]和GSH-Px活力[ (59.53±25.23)kU/L]明显低于内对照组[(153.32±24.31)、(63.06±13.66) μg/L,(91.88±22.99)kU/L]和外对照组[ (242.35±38.56)、(98.93±17.18)μg/L,( 122.68±41.74)kU/L],且内对照组明显低于外对照组(P均＜ 0.05)；KBD组和内对照组SOD活力[(55.80±8.14)、(57.45±6.96)kU/L]、CAT活力[(16.45±5.61)、( 15.63±9.18)kU/L]和T-AOC水平[(19.80±6.64)、(21.71±8.82)kU/L]均高于外对照组[(42.79±8.10)、(6.05±2.71)、(13.56±5.38)kU/L,P均＜0.05]；KBD组MDA水平[(4.64±1.11 )μmol/L]高于内对照组[(3.31±1.22) μmol/L]和外对照组[(3.43±1.29) μmol/L,P均＜0.05].结论 KBD存在氧化应激损伤,抗氧化酶在KBD病区儿童血清中升高是一种代偿性反应,体内氧自由基损伤与KBD的发生发展可能有一定的关系.

abstractsObjective To observe the activities of serum peroxidase capacity,and lipid peroxidation of children from Kaschin-Beck disease (KBD) areas of Xinghai county in Qinhai province,and to explore the relationship between antioxidant capacity and KBD.Methods Sixty four KBD and forty six health subjects without KBD were chosen from KBD endemic areas,which included primary schools of Tangnaihai,Xialujuan and Qushian of Xinghai county in Qinghai province,and fifty nine age-matched healthy control subjects without KBD were from a non-KBD endemic area,Nanfan primary school of Chang'an county in Shaanxi province.Twenty patients with KBD and twenty control subjects from KBD areas and non-KBD area were extracted by simple random sampling method.2,3-DAN fluorescence technique was used to test the hair and blood selenium.The biochemical techniques were used to test the indicators of oxidative stress including malondialdehyde(MDA),antioxidant enzyme activities,total antioxidant capacity(T-AOC),serum superoxide dismutase(SOD),catalase(CAT) and glutathione peroxidase(GSHPx).Results All patients with KBD had significantly lower serum GSH-Px activities[ (59.53 ± 25.23)kU/L] and selenium levels in hair[ (67.64 ± 17.28)μg/L] and blood[(36.27 ± 13.29)μg/L],respectively,than that of control subjects from KBD areas [ ( 91.88 ± 22.99 ) kU/L,( 153.32 ± 24.31 ) μg/L,( 63.06 ± 13.66) μg/L ] and nonKBD areas[ ( 122.68 ± 41.74)kU/L,(242.35 ± 38.56)μg/L,(98.93 ± 17.18)μg/L,all P ＜ 0.05].Serum MDA levels in KBD patients[ (4.64 ± 1.11 )μmol/L] were significantly higher than that in control subjects from KBD [(3.31 ± 1.22)μmol/L] and non-KBD areas[ (3.43 ± 1.29)μmol/L,all P ＜ 0.05].On the other hand,T-AOC,SOD and CAT activities were significantly higher in both KBD[(19.80 ± 6.64),(55.80 ± 8.14),(16.45 ± 5.61 ) kU/L] and control subjects[ (21.71 ± 8.82),(57.45 ± 6.96),(15.63 ± 9.18)kU/L] from KBD areas than that of control subjects from non-KBD area[ (13.56 ± 5.38),(42.79 ± 8.10),(6.05 ± 2.71 )kU/L,all P ＜ 0.05 ].Hair selenium levels,blood selenium levels and GSH-Px activity of control subjects from KBD areas were,respectively,significantly lower than that in control subjects from non-KBD area(all P ＜ 0.05).Conclusions These findings strongly confirm the evidence that KBD patients are susceptible to oxidative stress.The results also show the increase in antioxidant enzymes,which could probably be due to adaptive response to pro-oxidant in KBD state.Hence,there seems to be an imbalance between oxidant and antioxidant systems in KBD patients.