不同血液净化方式对清除晚期氧化蛋白产物的效果及对心血管预后的影响

目的观察尿毒症患者血清晚期氧化蛋白产物水平，对比不同血液净化方式对其清除效果，探讨其与心血管疾病的关系。方法将60例维持性血液透析患者随机分为单纯血液透析（HD）组、血液透析联合血液透析滤过（HD＋HDF）组和血液透析联合血液灌流（HD＋HP）组，每组20例；另设健康对照及尿毒症未透析组，观察12个月。结果尿毒症未透析组血清晚期氧化蛋白产物明显高于健康对照组（P〈0．01），透析后进一步升高（P〈0．05）；12个月后，HD＋HDF组及HD＋HP组血清晚期氧化蛋白产物水平及心血管并发症发生率低于HD组（P〈0．05）。结论①尿毒症患者HD后血清晚期氧化蛋白产物水平升高；②HD＋HDF或HD＋HP血液灌流能降低尿毒症患者血清晚期氧化蛋白产物水平，改善维持性血液透析患者心血管预后。

Removal of serum advanced oxidation protein products by different purification methods and their effecton cardiovascular morbidity in patients with maintenance hemodialysis

Objective To observe the levels of serum advanced oxidation protein products （AOPP） in uremic patients and compare the removal effects of different purification methods on AOPP to evaluate the relevance between AOPP and cardiovascular morbidity. Methods Sixty patienis subject to maintenance hemodialysis （MHD） were divided into 3 goups： Ohemodialysis （HD, n = 20） he- modialysis and hemodiafiltration （HD ＋ HDF, n = 20） （）hemodialysis and hemoperfusion （HD ＋ HP, n = 20）. The related indexes before treatment and 12 months after three kinds of blood purification were tested. Twenty healthy volunteers served as controls and 10 uremic patients with HD as positive con- trols.. Results The levels of AOPP were significantly higher in positive controls group than in vormal controls group,which were even higher in MHD group. After treatment for 12 months, the levels of AOPP and cardiovascular morbidity of HD ＋ HDF group and HD ＋ HP group were lower than those of HD group. Conclusions Serum levels of AOPP were increased in uremic patients which were higher in MHD patients, HD combined with HDF or HP can significantly clear AOPP and improve the cardio- vascular prognosis.