血液透析对血管内皮功能的影响及氟伐他汀的作用

目的：探讨血液透析对血管内皮功能有无损伤及氟伐他汀对该类病人的内皮功能有无保护作用和可能的机制。方法：以16名维持性血透患者为对象，分别在应用和不用氟伐他汀的情况下，单次血透前后测量上臂动脉扩张度、血浆氧化应激标志物丙二醛（MDA）、脂质过氧化物（LPO）、血浆抗活性氧基标志酶--谷光甘肽过氧化物酶（GSH-Px）、血脂，比较血透前后和用药前后各指标的差异。结果：维持性血透病人血透后血管内皮功能较血透前降低，体内氧化应激性增强。在应用氟伐他汀后患者透析后体内氧化应激活性减低，因血透所致的内皮功能损害也减轻。结论：血液透析加重血管内皮功能损害，其机制可能与其引起氧化活性产物增加有关，而氟伐他汀对这种损害发挥保护作用。

Effect of Hemodialysis on Endothelial Function and Protective Effect of Fluvastatin

Objective:To investigate the influence of single hemodialysis on endothelial function in humans and whether fluvastatin can provide protection to this kind of patients.Methods:Subjects of maintenane hemodialysis were investigated.Endothelial function was determined using vascular ultrasound to measure flow mediated dilatation of brachial artery and data were compared with that of dilatation caused by sublingual glyceryl trinitrate.Endothelial function,plasma malondialdehyde(MDA),lipid peroxidate(LPO)and glutathione peroxidase(GSH Px)were assessed before and after a single dialysis treatment,which performed before and after fluvastatin treatment respectively.Results:Hemodialysis decreased the flow mediated dilatation.The plasma concentrations of MDA and LPO increased and GSH Px decreased after a single hemodialysis.After one week of fluvastation treatment,all these indexes improved.Conclusion:Hemodialysis injures endothelial function,which might related with the enhanced oxidative stress.Fulvastatin can provide protective effects to endothelial function.