抗坏血酸透析液对尿毒症患者静脉铁剂诱导的氧化应激影响

目的 观察抗坏血酸透析液对静脉铁剂诱导的维持性血液透析患者氧化应激的影响。方法 选择应用氢氧化铁蔗糖复合物治疗的维持性血液透析患者10例,分别给予抗坏血酸透析液透析和在透析过程中静脉滴注抗坏血酸进行干预,测定血浆及红细胞丙二醛(MDA)、抗坏血酸和维生素E水平,通过计算MDA:胆固醇的曲线下面积(AUC0-180min)判断其疗效。结果 氢氧化铁蔗糖复合物注射后,血糖MDA明显升高(P<0.05),60 min达高峰,抗坏血酸水平明显下降。抗坏血酸透析液可明显降低血浆MDA和AUC0-180min(P<0.05),静脉注射抗坏血酸也可降低血浆MDA,但至后期出现再次升高的趋势,其AUC0-180min与未用抗坏血酸相比无显著性差异。结论 抗坏血酸透析液可明显降低维持性血液透析患者由静脉铁剂诱导的氧化应激,效果优于静脉注射途径。

Ascorbic Acid Dialysate Attenuate Oxidative Stress Induced by Intravenous Iron Infusion in Chronic Hemodialysis Patients

Purpose To observe the effects of ascorbic acid on the oxidative stress induced by intravenous iron in chronic hemodialysis patients. Methods Ten cases of hemodialysis patients treated with ferric,receiving ascorbic acid dialysate and intravenous infusion of ascorbic acid, respectively. The levels of malon-di-aldehyde (MDA) ,ascorbic acid, vitamin E and cholesterol in erythrocytes and plasma were measured. The effects of treatment were evaluated by calculating the areas under the curve (AUC0-180 min) of ratios of plasma MDA to cholesterol. Results After the infusion of ferric, the plasma MDA lvevl increased significantly (P<0.05) and reached peak lvel after 60 minutes. The level of plasma ascorbic acid decreased distinctively. The ascorbic acid dialysate could decrease the plasma MDA and AUC0-180 min significantly (P<0. 05). Intravenous ascorbic acid could also reduce the plasma MDA, but later a trend of increasing again. Compared with the group unused ascorbic acid, AUC0-180min was not significantly reduced. Conclusions Ascorbic acid dialysate can significantly attenuate the oxidative stress induced by intravenous iron in patients on hemodialysis and its effect is better than the ntraenous ascorbic acid.