维持性血液透析患者氧化应激水平及其相关因素的分析

Oxidation stress in maintaining hemodialysis patients and its determinants

目的探讨维持性血液透析患者氧化应激水平及其相关影响因素。方法测定30例维持性血液透析患者血清丙二醛（MDA）和SOD水平，并与正常人比较，分析C反应蛋白、动脉粥样硬化与氧化应激的关系以及血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、不同的血液净化方式对维持性血液透析患者氧化应激水平的影响。结果维持性血液透析患者氧化应激水平明显增高，与C反应蛋白、动脉粥样硬化的形成明显相关，使用血管紧张素转换酶抑制剂或血管紧张素Ⅱ受体拮抗剂以及进行血液透析滤过治疗的透析患者血清MDA水平明显降低（P〈0．01）。结论维持性血液透析患者氧化应激水平较正常人明显升高，有动脉硬化并发症者升高更明显。血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂、血液透析滤过治疗能减轻维持性血液透析患者的氧化应激水平。

Objective To explore the factors that influence the oxidation stress of maintaining hemodialysis （MHD） patients. Method Thirty patients （hemodialysis 20, hemodiafiltration 10） were selected. Blood MDA （malondialdehyde） and SOD were measured and compared with the controls. Results The level of indexes of oxidation stress of MHD patients was higher than those in controls. （P〈0. 01 ）, and was correlated with C reactive protein and atherosclerosis, The patients with atherosclerosis have higher levels of MDA and SOD than those without atherosclerosis （P〈0. 01 ）. The levels of MDA and SOD in MHD patients taking angiotensin converting enzyme inhibitors（ACEIs） or angiotensinII receptor blockers（ARBs） and received hemodiafiltration treatment were lower than those patients not taking ACEIs or ARBs and hemodialysis patients （P〈0. 01 ）. Conclusions Oxidation stress in MHD patients is higher than that in controls. ACEIs or ARBs and hemodiafiltration treatment may alleviate the oxidation stress of MHD patients.