维生素E对血液透析病人氧化应激的干预效果

目的　研究抗氧化剂维生素E对血液透析病人氧化应激状态的干预效果。方法　处于稳定状态的血液透析病人 5 6例 (不服用任何抗氧化药)采用自身对照的方法 ,观察 1个月后 ,随机均分为两个实验组 ,A组口服维生素E 2 0 0mg/d ,B组口服维生素E 4 0 0mg/d,服药 1个月 ;两组分别在观察期和服用维生素E干预期前后检测循环晚期氧化蛋白产物(AOPP)、丙二醛 (MDA)和谷胱甘肽过氧化物酶(GSHPx)水平以及血清维生素E浓度。另选 5 6例健康者作为正常对照组。结果　实验组血清AOPP、MDA水平明显高于同龄正常对照组(n =5 6 ,P <0 0 1) ,GSHPx、维生素E浓度明显低于正常人(P <0 0 1) ;透析病人在未服抗氧化药的 1个月观察期前后AOPP、MDA、GSHPx及维生素E浓度无明显变化 (P均 >0 0 5 ) ;A组治疗后 ,血清维生素E水平较治疗前明显增高 (P <0 0 1) ,但AOPP、MDA和GSHPx水平与治疗前相比无明显差异 ;B组治疗后血清维生素E、GSHPx水平较治疗前增高 (P <0 0 1,P <0 0 5 ) ,AOPP较治疗前明显降低 (P <0 0 1) ,但MDA水平无明显变化。结论　口服大剂量维生素E(4 0 0mg/d)可以改善血透病人的氧化应激状态 ;血透病人短期服用大剂量维生素E未见明显副作用。

The effect of vitamin E supplementation on oxidative stress in hemodialysis patients

Objective To investigate the effect of vitamin E supplementation on oxidative stress in hemodialysis patients. Methods Fifty-six uremic patients undergoing hemodialysis (HD) were involved in this self-controlled study. The patients were observed for one month to evaluate the status of oxidative stress and then divided into two groups randomly. Group A patients (n=28) received 200mg/d of vitamin E and Group B patients (n=28) were treated with 400mg/d of vitamin E. Vitamin E was supplied for one month in both groups. The serum levels of advanced oxidation protein products (AOPP), malondialdehyde (MDA), vitamin E and activity of glutathione peroxidase (GSHPx) were measured at the initial and the end of vitamin E supplementation respectively. Results Serum levels of AOPP and MDA were significantly higher in HD patients compared with healthy controls (n=56, P<0.01). Vitamin E concentration and GSHPx activity in HD patients were significantly lower than that in controls(P<0.01). There were no significant changes in the above parameters of oxidative stress in HD patients during one month observation period. High dosage of vitamin E supplementation (group B) decreased serum AOPP level(P<0.01)and increased serum vitamin E level(P<0.01)and GSHPx activity (P<0.05)significantly, but had no significant influence on serum MDA level, whereas low dosage of vitamin E supplementation (group A) showed no effect on serum levels of AOPP, MDA and GSHPx activity, although it increased serum vitamin E level (P<0.01)significantly. Conclusion Short-term supplementation of high dosage of vitamin E ameliorated oxidative stress in HD patients without apparent side effect.