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目的观察长期口服维生素E(VitE)对静脉铁剂诱导的腹膜透析患者氧化应激(OS)的影响。方法选择2008年1—12月郑州大学第一附属医院维持性腹膜透析患者40例,随机分为静脉铁剂对照组(Fe组,予低分子右旋糖酐铁总剂量注射)和静脉铁剂联合VitE干预组(Fe+VitE组,予低分子右旋糖酐铁总剂量注射+VitE口服400mg/d),另选同年龄、健康对照组20例,慢性肾衰竭未透析患者20例(CRF组),检测试验前后各组血浆丙二醛(MDA)、血浆晚期蛋白质氧化产物(AOPP)、血清超氧化物歧化酶(SOD)、血清谷胱甘肽过氧化物酶(GSH-Px)的含量。观察时间8周。结果试验前与健康对照组相比,CRF组、Fe组、Fe+VitE组SOD和GSH-Px含量显著性降低(P<0.05),MDA和AOPP含量增高(P<0.05),CRF组及两治疗组组间比较各项OS指标对比差异无统计学意义(P>0.05)。观察4周后,Fe组SOD和GSH-Px含量较试验前降低,但差异无统计学意义(P>0.05),MDA和AOPP含量均高于CRF组和Fe+VitE组(P<0.01),Fe+VitE组MDA和AOPP较Fe组明显下降(P<0.01),和CRF组相比,MDA含量变化无统计学差异,AOPP较CRF组明显升高(P<0.05)。结论 CRF患者处于OS状态;静脉补铁可加重CRF患者OS,此效应随时间延长持续存在;口服VitE可一定程度减轻腹透患者静脉铁剂所诱导的OS效应。
Objective To observe the effect of long-term oral administration of vitamin E on oxidative stress (OS) in peritoneal dialysis patients induced by intravenous iron. Methods Forty patients with maintenance peritoneal dialysis in the First Affiliated Hospital of Zhengzhou University from January to December in 2008 were randomly divided into intravenous iron control group (Fe group, total iron dextran injection) and intravenous iron combined with VitE Group (Fe + VitE group, low dose iron dextran injection + VitE oral 400mg / d), and the same age, healthy control group and 20 cases of chronic renal failure patients without dialysis in 20 cases (CRF group) before and after the test The levels of plasma MDA, AOPP, SOD and GSH-Px in each group were measured. Observation time of 8 weeks. Results Compared with healthy control group, the levels of SOD and GSH-Px in CRF group, Fe group and Fe + VitE group were significantly decreased (P <0.05) and MDA and AOPP levels were increased (P <0.05) There was no significant difference in each OS index between treatment groups (P> 0.05). After 4 weeks of treatment, the contents of SOD and GSH-Px in Fe group were lower than those before the test, but the difference was not statistically significant (P> 0.05). The contents of MDA and AOPP in Fe group were higher than those in CRF group and Fe + VitE group (P <0.01) Compared with CRF group, the content of MDA and AOPP in Fe + VitE group was significantly lower than that in Fe group (P <0.01). There was no significant difference in MDA content between A group and Fe + VitE group (P <0.01). Conclusions The patients with CRF are in OS state. Intravenous iron supplementation can increase the OS of CRF patients, and this effect persists with the prolongation of time. Oral VitE can relieve the OS effect induced by intravenous iron in the patients with CRP.