血液灌流对慢性肾功能衰竭患者体内抗氧化酶活性及脂质过氧化物的影响和分析

目的观察慢性肾功能衰竭患者体内脂质过氧化物及抗氧化酶活性的水平,并观察血液灌流对其的影响及可能机制。方法选择慢性肾功能衰竭患者60例,随机分为两组:血液灌流串联血液透析组(HP+HD组)和单纯血液透析组(HD组),每组各30例,分别于治疗前、后采血;健康人25名作为对照组;分别检测血浆中丙二醛(MDA)、超氧化物歧化酶(SOD)、总抗氧化能力(TAC)、谷胱甘肽过氧化物酶(GSH-Px)的水平。结果①透析及灌流治疗前两组患者血MDA、SOD水平均高于正常对照组,血TAC、GSH-Px水平均低于正常对照组,差异有统计学意义(P<0.05),两组治疗前各因子水平差异无统计学意义(P>0.05);②治疗后两组患者血MDA水平较治疗前明显降低,血SOD、TAC、GSH-Px水平均较治疗前明显升高,差异有统计学意义(P<0.05);③血液灌流串联血液透析组治疗后血MDA降低的水平、GSH-Px升高的水平较单纯血液透析组差异有统计学意义(P<0.05),而血SOD、TAC与透析组差异无统计学意义(P>0.05)。结论慢性肾衰竭患者存在着严重的氧化与抗氧化失衡,血液灌流是其有效的治疗手段。

Impacts of hemoperfusion on lipid peroxidation and antioxidase activities in patients with chronic renal failure

Objective To determine the impacts of hemoperfusion （HP） on serum lipid peroxidation and antioxi dases activities in patients with chronic renal failure （CRF）. Methods Sixty CRF patients registered to the Department of Nephrology, Second Affiliated Hospital of Shanxi Medical University, were randomized into two groups, namely the combined hemoperfnsion and hemodialysis group （HP＋HD group, n=30） and simple hemodialysis group （HD group, n=30）. Twenty-five healthy individuals were selected as normal controls （control group）. Before and after treatments, all subjects were collected of blood samples to determine serum levels of malondialdehyde （MDA）, superoxide dismutase （SOD）, total antioxidant capacity （TAC） and glutathione peroxidase （GSH-Px）. Results ①Prior to HP and/or HD, both treatment groups showed significantly higher levels of serum MDA and SOD, lower levels of serum TAC and GSH-Px than those in control group （P〈0.05）, with no significant differences in these levels between each other （P〉0.05）. ②After treatments, there was a significant decrease in serum MDA level and increases in the serum SOD, TAC and GSH- Px levels from baseline in both HP＋HD and HD groups （P〈0.05）. ③HP＋HD group showed greater reduction in serum MDA and greater increase in serum GSH-Px from baseline as compared with HD group （P〈0.05）, whereas the changes in serum SOD and TAC were similar the both groups （P〉0.05）. Conclusion HP may be an effective treatment in CRF where severe oxidative stress and antioxidative imbalance are occuring.