摘要
目的:探讨不同剂型铁剂对腹膜透析患者氧化应激状态的影响。方法:选择持续性不卧床腹膜透析(CAPD)患者31例,随机分为静脉组(Ⅰ组,11例),口服组(Ⅱ组,10例)和未补铁组(Ⅲ组,10例),观察用药前后血清C-反应蛋白(CRP)和丙二醛(MDA),谷胱苷肽过氧化物酶(GSH-Px),晚期糖基化终产物(AGEs),晚期氧化蛋白产物(AOPP)等炎症和氧化应激指标。结果:①3组患者治疗前AGEs,MDA,AOPP,CRP水平差异无显著性(P>0.05)但均高于健康对照组(P<0.05),GSH-px水平差异无显著性(P>0.05)但低于健康对照组(P<0.05)。②Ⅰ组患者使用静脉铁剂后1h,MDA,AOPP水平升高、GSH-px水平下降差异有显著性(P<0.05)。4周时MDA,AOPP时恢复至治疗前水平;GSH-px水平较1h时上升但仍显著低于治疗前及Ⅱ、Ⅲ2组,差异有显著性(P<0.05),8周时恢复至治疗前水平。③4周时Ⅰ组患者AGEs,CRP水平升高,较治疗前及1h差异有显著性(P<0.05)且高于Ⅱ、Ⅲ组。8周时AGEs水平与4周相比差异无显著性(P>0.05),但CRP水平已恢复至治疗前。Ⅱ、Ⅲ2组4周及8周时AGEs水平差异无显著性(P>0.05);Ⅱ组患者CRP水平在4周及8周时均高于Ⅲ组,差异有显著性(P<0.05)。④MDA水平4周及8周时Ⅱ、Ⅲ2组与治疗前变化差异无显著性(P>0.05);Ⅰ、Ⅱ、Ⅲ3组之间差异无显著性(P>0.05)。⑤4周时Ⅱ组AOPP水平升高,与治疗前相比差异有显著性(P<0.05)且高于Ⅰ、Ⅲ2组,8周时与4周相比差异无显著性(P>0.05)。Ⅲ组无变化(P>0.05)。结论:①CAPD患者接受静脉铁剂治疗时,可能会诱导炎症及氧化应激反应的加剧。②口服补铁4周后可引起CAPD患者AOPP水平的升高。③口服补铁4周后CAPD患者血清CRP水平高于未补铁患者。
OBJECTIVE To investigate the influence of different dosage forms of iron therapy on oxidative stress in peritoneal dialysis patients. METHODS Thirty-one continuous ambulatory peritoneal dialysis(CAPD) patients were randomly divided into intravenous iron group(group I , n = 11 ), oral iron group(group Ⅱ, n=10), and non-iron group(group Ⅲ, n=10). Their serum C-reactive protein (CRP), advanced oxidation protein products (AOPP) , malondialdehyde (MDA), advanced glycation end products(AGEs), glutathione peroxidase(GSH-Px) were measured at the different times of the study. Twenty healthy volunteers were as normal controls. RESULTS ①Before treatment there were no difference in three groups in AGEs, MDA, AOPP, CRP and GSH-px(P〉0. 05). The AGEs, MDA, AOPP, CRP were higher than contral group (P〈0.05), and the GSH-px was lower than contral group also(P〈0.05). ②After the infusion of intravenous iron, the MDA, AOPP levels in group I increased significantly and reached peak level after 1 hour, the levels of GSH-px decreased significantly in the meantime(P〈0.05) ,but after four-week MDA,AOPP decreased significantly to the level of before treatment(P〈0. 05); although the GSH- px levels increased after four weeks but were lower than those before treatment , the levels of lh,group Ⅱ and groupⅢ and returned to the previous after eight weeks(P〈0.05).③The AGEs,CRP levels in group I at the 4^th week of trial were higher than those before treatment , lh, group Ⅱ and group Ⅲ(P〈0.05); Although at the end of study the levels of CRP returned to the previous but the levels of AGEs is not quite different compared with the 4^th week(P〉0.05), Comparison of the AGEs levels in the group I and group Ⅱ showed insignificant difference(P〉0.05)at the 4^th week and 8^th week. but the levels of CRP on group was significantly higher than groupⅢ at 4^th week week 4 and 8^th week(P〈0.05). ④After eight-week observation period, the MDA levels was no significantly change in group Ⅱ and groupⅢ(P〉0.05), there were no significantly difference among group I ,group Ⅱ and group Ⅲ(P〉0.05).⑤After four-week observation period, the AOPP levels of group Ⅱ were higher than those before treatment and group I and group Ⅲ (P〈0.05). there were no significantly difference between the the levels of week 4 and week 8(P〉0.05) . There was no any change in groupⅢ(P〉0.05). CONCLUSION ①Maybe intravenous iron supplementation also aggravates the status of oxidative stress and inflammation. ②The AOPP levels in CAPD increased signifi-cantly when oral iron administration for 4 weeks. ③When oral iron supplementation for 4 weeks the levels of CRP were higher than no iron group.
出处
《中国医院药学杂志》
CAS
CSCD
北大核心
2007年第11期1556-1559,共4页
Chinese Journal of Hospital Pharmacy
基金
广东省珠海市科技资助项目(编号:PC20041012)
关键词
腹膜透析
铁剂
氧化应激
continuous ambulatory peritoneal dialysis, intravenous iron, oxidative stress