尿毒症维持性透析患者炎症和氧化应激状态相关因素分析

目的分析尿毒症维持性透析患者炎症和氧化应激状态的相互关系及影响因素。方法分光光度法及免疫比浊法测定尿毒症患者血清超氧化物歧化酶（SOD）、维生素E（VitE）、维生素C（VitC）、丙二醛（MDA）、C-反应蛋白（CRP）。结果与非尿毒症相比，尿毒症患者SOD、VitE、VitC水平较低（P〈0．01），CRP和MDA浓度较高（P〈0．01）。腹膜透析患者SOD、VitC、VitE水平高于血仿膜透析组（P〈0．05）。与聚砜膜透析组无差异；MDA水平低于两血液透析组（P〈0．05）；CRP水平与血液透析组无差异。聚砜膜组VitC、VitE水平高于血仿膜组，SOD、MDA及CRP水平两组间无差异（P〉0．05）。结论尿毒症患者处于炎症和氧化应激状态。尿毒症炎症和氧化应激互为因果，相互作用。血液净化方式的选择对尿毒症炎症、氧化应激及羰基应激的影响尚不确定。

Evaluation of inflammation and oxidative stress and analysis of the correlation factors in uremic patients undergoing dialysis

Objective To evaluate the states of inflammation and oxidative stress in uremic patients and analyze their relationship.Methods Spectrophotometry and immune turbidimetry were used to measure the serum superoxide dismutase(SOD),vitamin C and E,malondialdehyde(MDA) and C reactive protein(CRP) levels.Results Compared with non-uremia groups,there were lower serum SOD,vitamin E and C levels(P<0.01),higher CRP and MDA levels in uremia groups(P<0.01).In peritoneal dialysis group,there were higher SOD,vitamin C and E levels than hemodialysis group(P<0.05),and were no differences when compared with PS group. MDA level was lower in peritoneal dialysis group than that in hemodialysis groups,but there were no significant differences in CRP level between them.Compared with hem group,there were higher vitamin C and E levels in PS group,but the same SOD,MDA and CRP levels.Conclusion Uremic patients are in a inflammatory and oxidative-stress state.At the same time the oxidative stress and inflammation are coordinative and interactive.Whether dialysis methods can influence uremic inflammatory or oxidative-stress state has not been clearly elucidated.