终末期肾病氧化应激状态的研究

为了解氧化应激状态及肾替代治疗对终末期肾病(ESRD)患者的影响 ,笔者比较了正常人、慢性肾功能不全 (CRF)、腹膜透析(CAPD)和血液透析 (HD)病人之间血浆还原型谷胱甘肽 (GSH)、维生素E、丙二醛 (MDA)和蛋白羰基含量及全血谷胱甘肽过氧化物酶(GPx)活性的差异。结果显示与正常人相比 ,CRF病人循环GSH浓度和GPx活性降低 (P均 <0 0 5 ) ,CAPD和HD病人循环GSH、维生素E浓度和GPx活性均明显降低 (P均 <0 0 5 ) ,而血浆MDA和蛋白羰基含量均显著升高 (P均 <0 0 5 ) ;HD患者血浆GSH和维生素E含量比CRF组降低(P均 <0 0 5 )。提示ESRD患者处于氧化应激状态 ,血液透析进一步加剧这种病理生理改变

OXIDATIVE STRESS IN END STAGE RENAL DISEASE

To observe changes in oxidative stress and effects of dialysis on patients with end stage renal disease (ESRD), vitamin E, GSH, malondialdehyde (MDA) levels in plasma and carbonyl contents of plasma proteins, and blood glutathione peroxidase (GPx) activity were assayed in healthy individuals, chronic renal failure (CRF) patients before dialysis, and after hemodialysis (HD) or peritoneal dialysis (PD). As compare with healthy control, plasma levels of vitamin E and GPx activity of CRF patients were lower, whereas plasma contents of both MDA and carbonyl content of plasma proteins were increased significantly ( P <0 05). In PD group and HD group, plasma levels of vitamin E, GSH, and GPx activity were decreased ( P <0 05), and plasma contents of MDA and carbonyl content of plasma proteins were increased significantly ( P <0 05) compared with those of healthy control. Plasma levels of vitamin E and GSH in HD group were lower than those of CRF group ( P <0 05). These results suggest that oxidative stress occurs in ESRD patients, which might be aggravated by hemodialysis.