维持性血液透析患者微炎症及氧化应激与动脉粥样硬化的关系

The relationship of artherosclerosis with microinflammation and oxidative stress in MHD patients

目的:探讨维持性血液透析患者微炎症及氧化应激状态与动脉粥样硬化的关系。方法:测定35例1年以上透析充分的维持性血液透析(maintenance hemodialysis,MHD)患者透析前血肌酐(Scr)、血尿酸(UA)、血糖(Glu)、血浆白蛋白(ALB)、甘油三酯(TG)、胆固醇(TC)、C反应蛋白(CRP)、IL-6、肿瘤坏死因子α(TNF-α)、血浆丙二醛(malondialdehyde,MDA)、超氧化物歧化酶(superoxide dismutase,SOD)、血浆谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-Px)。应用超声测定颈动脉中层厚度(IMT)及有无颈动脉斑块形成。结果:AS组CRP、IL-6及TNF-α明显高于非AS组,两组之间差异有显著性(P<0.05);同时,AS组血清MDA水平显著高于非AS组,SOD和GSH-Px水平显著低于非AS组,两组差异有显著性(P<0.05)。而两组在年龄、性别构成、血压、血脂、血糖、血尿酸无统计学差异。结论:微炎症及氧化应激共同参与了MHD患者动脉粥样硬化的形成。

Objective：To investigate the relationship between artherosclerosis, oxidative stress and microinflammation in hemodialysis patients.Methods：Thirty-five maintenance hemodialysis（MHD） patients were randomly divided into AS group and non-AS group.The level of CRP,IL-6, tumornecrosis factor（TNF）-α, serum creatinine,serum uric acid,glucose,albumin,triglyceride（TG） , total cholesterol（TC）, malondialdehyde （MDA）,superoxide dismutase （SOD）, and glutathione peroxidase （GSH-Px） were measured from 35 patients who had more than l years maintenance hemodialysis history.Intima-medial thickness （IMT） of extracranial common carotid artery and the presence of atherosclerotic plaques was determined by using noninvasive high-resolution B-mode uhrasonography.Results：Levels of plasma CRP,IL-6 and TNF-α in AS group were higher than those in non-AS group （P0.05）.Levels of MDA in AS group were higher than those in non-AS group,while SOD,GSHPx were lowerthan those in non-AS group （P0.05）.Meanwhile,there was no significant diferences on serum TC,TG,blood pressure,glucose, albumin and uric acid between two groups.Conclusion：The complex interaction between oxidative stress and microinflammation may result in accelerated atherosclerosis seen in CRF.