维生素E修饰透析膜对血液透析患者红细胞抗氧化应激的效果

Effects of vitamin E-modified dialysis membrane on anti-oxidant stress of RBC in patients with haemodialysis

目的 观察VitE修饰的透析膜 (CL E)对血透患者红细胞生成素 (rH EPO)疗效的影响。方法 选 40名血透患者停EPO一个月 ,并随机分为二组 ,A组 ( 2 0例 )用CL E ;B组 ( 2 0例 )用常规透析膜 ,观察 6周。实验开始时两组同时给与同样剂量 (每周 15 0IU/kg)rH EPO治疗 ,分别于实验第 1、4、7、10、13、16、19次透析前测血常规 ,第 7、19次透析前取空腹血 ,测定血浆和红细胞中丙二醛 (MDA)、VitE及红细胞中谷胱甘肽 (GSH)、过氧化物歧化酶 (SOD)浓度。结果 实验结束时A组血浆VitE水平比实验前明显升高 ,MDA明显下降 ;红细胞中VitE、GSH及SOD明显升高 ,MDA明显下降 (P均 <0 .0 5 )。B组实验前后无明显变化。A组Hb水平在实验 4周时较实验前明显提高(P <0 .0 5 ) ,B组在 6周时发现 ,A组Hct水平在实验 3周时较实验前明显提高 (P <0 .0 5 ) ,B组在 5周时才出现。结论 CL E有抗氧化作用 ,使rH EPO的升血作用提前出现 。

Objective To evaluate the effects of vitamin E-modified dialysis membrane (CL-E) on rH-EPO therapy in patients with haemodialysis.Methods Forty patients with maintenance haemodialysis who had suspended EPO administration for one month were dividedly randomly into two groups.Patients in group A(n=20) received CL-E;patients in group B(n=20) received merely conventional haemodialysis for 6 weeks.At the initiation of this study,equal doses of rH-EPO(150 IU/kg.W) was administered simultaneously in both groups while blood samples were collected prior to the 1st,4th,7th,10th,13th,16th and 19th dialysis for blood routine test.Malonylaldehyde(MDA) and vitamin E in plasma and red blood cells(RBC),glutathione(GSH) and superoxide dismutase(SOD) in RBC were determined prior to the 7th and 19th dialysis.Results In group A,plasma vit E was significantly increased(P=0.003) MDA was obviously declined(P=0.043).Vit E(P=0.032),GSH(P=0.017) and SOD(P=0.048) were significantly increased MDA (P=0.033) obviously declined in RBC.In group B,all the relevant parameters did not significantly change.Hb level in group A began to markedly increase in the 4th week of the study(P= 0.048)whereas it markedly increased in the 6th week in group B(P=0.049).Hct level in group A markedly increased in the 3rd week(P=0.044) whereas it increased in the 5th week in group B(P= 0.049).No statistical difference of parameters was demonstrated between group A and B.However,the increase of Hb and Hct levels in group A was earlier than that in group B.Conclusions Vit E-modified membrane may have anti-oxidant effects on haemodialysis patients and exhibit an advantage in facilitating the effect of rH-EPO.