Detection Of Serum Oxidative Stress And Endothelial Cell Injury Factors And Its Clinical Significance In Idiopathic Membranous Nephropathy Patients

Objective:To explore the expression level and clinical significance of the serum oxidative stress markers Superoxide dismutase,malondialdehyde and endothelial cell injury markers von Willebrand factor and E-selectin in patients with idiopathic membranous nephropathy in stage 1 to 3 of chronic kidney disease.Methods:Collected the pathological and clinical data of patients undergoing renal biopsy in the Department of Nephrology,the First Affiliated Hospital of Guangxi Medical University,selected 48 patients diagnosed with idiopathic membranous nephropathy as the case group and 20 cases of Minimal change disease patients and 38 cases of IgA nephropathy patients as the positive control group,and 50 healthy subjects with matching age and gender at the same time were selected as negative control group.Enzyme-linked immunosorbent assay method was used to determine endothelial cell injury markers vWF and E-selectin.WST-1 method was used to measure oxidative stress marker superoxide dismutase.The TBA method was used to determine the oxidative stress marker malondialdehyde and to explore its correlation with clinical indicators.Results:?1?Comparison between groups:The level of SOD in IMN group,IgAN group and MCD group were significantly lower than that in the negative control group,both of the differences were statistically significant?P<0.01?,and the SOD level in IMN group was lower than that in the IgAN positive control group,the difference was statistically significant?P<0.05?;MDA level in the IMN group and IgAN group were higher than that in the negative control group,MDA level in the IgAN group was higher than that in the MCD group,both of the differences were statistically significant?P<0.05?;The level of CD62E in IMN group and IgAN group were higher than those in the negative control group.The level of CD62E in IgAN group was higher than that in the MCD group,both of the differences were statistically significant?P<0.05?.The level of vWF in IMN group,IgAN group and MCD group were significantly higher than that in the negative control group?P<0.01?.?2?Correlation analysis:The serum level of SOD in IMN patients were positively correlated with CD62E,Tbil,Dbil,Ibil,Alb,IgG and TT₃ and was negatively correlated with TSH?P<0.05?.The serum MDA level in IMN patients were positively correlated with IgG and IgA and was negatively correlated with CysC and TSH?P<0.05?.The serum CD62E level in IMN patients were positively correlated with SOD,BUN and IgG?P<0.05?.The serum vWF level in IMN patients were positively correlated with complement C₃?P<0.05?.?3?Multiple linear regression analysis:Among patients with idiopathic membranous nephropathy in stage 1 to 3 of chronic kidney disease,CD62E and serum albumin were the influencing factors of serum SOD levels in idiopathic membranous nephropathy patients;eGFR and CysC were the influencing factors of serum MDA levels in idiopathic membranous nephropathy patients;SOD and 25?OH?D₃ were the influencing factors of serum CD62E levels in idiopathic membranous nephropathy patients.Conclusion:There was an imbalance of oxidative stress and endothelial cell damage in patients with idiopathic membranous nephropathy in stage 1 to 3 of chronic kidney disease,which was characterized by decreased levels of antioxidant enzyme SOD,elevated levels of lipid peroxide MDA,and elevated levels of CD62E and vWF.Oxidative stress imbalance may be related to endothelial cell injury and the level of serum albumin,serum bilirubin,thyroid function and immunoglobulin;endothelial cell damage may be related to the level of SOD,urea nitrogen and immunoglobulin;oxidative stress and endothelial cells Injury was closely related to clinical,and both may participate in the pathophysiological process of idiopathic membranous nephropathy.