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埃及镰状细胞贫血患儿的氧化应激-抗氧化状态:一项基于单中心的研究

Oxidant-antioxidant status in Egyptian children with sickle cell anemia: a single center based study.

作者信息

El-Ghamrawy Mona Kamal, Hanna Wagdi Maurice, Abdel-Salam Amina, El-Sonbaty Marwa M, Youness Eman R, Adel Ahmed

机构信息

Department of Pediatrics, New Children's Hospital, Cairo University, Cairo, Egypt.

Department of Child Health, National Research Center, Cairo, Egypt.

出版信息

J Pediatr (Rio J). 2014 May-Jun;90(3):286-92. doi: 10.1016/j.jped.2013.09.005. Epub 2014 Feb 5.

Abstract

OBJECTIVE

the present study was conducted to investigate the oxidant-antioxidant status in Egyptian children with sickle cell anemia.

METHODS

the serum levels of total antioxidant capacity (TAO), paraoxonase (PON), vitamin E, nitrite, and malondialdehyde (MDA) were measured in 40 steady state children with homozygous sickle cell anemia (24 males and 16 females) and 20 apparently healthy age- and gender-matched controls.

RESULTS

mean serum TAO, PON, vitamin E, and nitrite levels were significantly lower in the group with sickle cell anemia, whereas mean serum MDA was significantly higher in these children compared to controls. No significant differences in mean levels of TAO, PON, nitrite, vitamin E, and MDA were found in sickle cell anemia patients receiving hydroxyurea when compared with those not receiving hydroxyurea. A significant negative correlation between serum nitrite and the occurrence of vaso-occlusive crises (VOC) was observed (r=-0.3, p=0.04). PON level was found to be positively correlated with patients' weight and BMI (r=-0.4, p=0.01; r=-0.7, p<0.001, respectively), but not with frequency of VOC. The area under the curve of serum nitrite in predicting occurrence of VOC was 0.782, versus 0.701 for PON, and 0.650 for TAO (p=0.006). Serum MDA was not correlated with nitrite, PON, TAO, or vitamin E levels. No significant correlations were detected between serum nitrite and hemoglobin or antioxidant enzymes.

CONCLUSION

children with sickle cell anemia have chronic oxidative stress that may result in increased VOC, and decreased serum nitrite may be associated with increases in VOC frequency. A novel finding in this study is the decrease in PON level in these patients, which is an interesting subject for further research.

摘要

目的

本研究旨在调查埃及镰状细胞贫血患儿的氧化-抗氧化状态。

方法

对40例纯合子镰状细胞贫血稳态患儿(24例男性和16例女性)以及20例年龄和性别匹配的明显健康对照者,测定其血清总抗氧化能力(TAO)、对氧磷酶(PON)、维生素E、亚硝酸盐和丙二醛(MDA)水平。

结果

镰状细胞贫血组患儿的血清TAO、PON、维生素E和亚硝酸盐平均水平显著低于对照组,而这些患儿的血清MDA平均水平显著高于对照组。与未接受羟基脲治疗的镰状细胞贫血患者相比,接受羟基脲治疗的患者在TAO、PON、亚硝酸盐、维生素E和MDA平均水平上无显著差异。观察到血清亚硝酸盐与血管闭塞性危机(VOC)的发生呈显著负相关(r=-0.3,p=0.04)。发现PON水平与患者体重和体重指数呈正相关(分别为r=-0.4,p=0.01;r=-0.7,p<0.001),但与VOC发作频率无关。血清亚硝酸盐预测VOC发生的曲线下面积为0.782,PON为0.701,TAO为0.650(p=0.006)。血清MDA与亚硝酸盐、PON、TAO或维生素E水平无相关性。血清亚硝酸盐与血红蛋白或抗氧化酶之间未检测到显著相关性。

结论

镰状细胞贫血患儿存在慢性氧化应激,这可能导致VOC增加,血清亚硝酸盐降低可能与VOC发作频率增加有关。本研究的一个新发现是这些患者的PON水平降低,这是一个值得进一步研究的有趣课题。

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