黄芪对血液透析患者肿瘤坏死因子和脂蛋白（a）的影响

目的：探讨黄芪对慢性肾功能衰竭血液透析（HD）患者肿瘤坏死因子－α（TNF-α）和脂蛋白（a)Lp(a)]的影响。方法：用RIA法和ELISA法分别测定21例HD患者在HD前、后及黄芪治疗后血清TNF－α,Lp(a)、载脂蛋白B（Apo-B)、总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL－C）、极低密度脂蛋白胆固醇（VLDL－C）均升高（P＜0．01），而Apo-A1,Apo-A1/Apo-B、高密度脂蛋白胆固醇（HDL－C）均降低（P＜0．01）。HD前、后TNF－α和血脂各值均无明显变化（P＞0．05）。黄芪治疗后TNF－α，Lp(a)、TC、TG，LDL－C、VLDL－C均降低（P＜0．05或P＜0．01），而Apo-A1,Apo-A1/Apo-B,HDL-C均升高（P＜0．05或P＜0．01）。结论：（１）维持性ＨＤ患者有TNF－α升高和高脂血症。（２）HD不能纠正TNF－α异常和脂质代谢紊乱。（3）黄芪对维持性HD患者的TNF－α异常和脂质代谢紊乱有调节作用。

Effect of Astragali on Tumor Necrosis Factor and Lipoprotein (a) in Hemodialyzed Patients

To explore the effect of astragali on tumor necrosis factor- (alpha) (TNF-α) and lipoprotein (a) 〔 Lp(a) 〕 in hemodialyzed (HD) patients. Methods:Double antibody sandwich ELISA and RIA were used to determine serum Lp(a) and TNF-α levels from 21 HD patients (pre-and post-hemodialysis, after astragali treatment). Results: Serum TNF-α, Lp(a),apolipoprotein B (apo B), total cholesterol ( TC ), triglyceride ( TG ), low density lipoprotein-cholesterol (LDL-c) and very low density lipoprotein-cholesterol (VLDL-c)concentrations in H-D patients were significantly higher than those in control (P ＜0.01). Serum apo A1, apo A1/apo B and high density lipoprotein-cholesterol (HDL-c) levels were significantly lower than those of normal control (P ＜0.01). There were no changes of TNF-α and lipid levels in 21 HD patients between preand post-hemodialysis (P＞ 0.05 ). After astragali treatment, the levels of TNF-α, Lp (a), TC, TG, LDL-c and VLDL-C were decreased (P＜0.05 or P＜0.01) ,and the levels of apo Al,apo Al/apo B,HDL-c were increased (P＜0.05 or P＜0.01 ). Conclusion: (1)The continuous HD patients were characterized by the increased TNF-α and hyperlipoproteinemia.(2)The disorder of TNF-α and lipid metabolism could not be corrected with HD. (3)The astragali treatment could improve the disorder of TNF-α and lipid metabolism in HD patients.