维持性血液透析患者氧化应激状态的影响因素及黄芪注射液对其的作用研究

Assessment of the Influencing Factors and the Effects of Astragalus Root Injection on Oxidative Stress State in Maintenance Hemodialysis Patients

目的:探讨维持性血液透析患者氧化应激状态的相关影响因素,以及血液透析过程中滴注黄芪注射液对氧化应激的影响。方法:入选本院血液净化中心54例维持性血液透析患者。检测指标包括人体学测量、血生化指标、透析充分性指标(eKt/V)、氧化应激指标(AOPP、MDA)等。同时,观察血透过程中予以黄芪注射液滴注维持后血清氧化应激指标的变化。结果:(1)AOPP与干体重、肱三头肌皮褶厚度、三酰甘油呈正相关,与高密度脂蛋白、eKt/V呈负相关(P<0.05);MDA与干体重、体重指数呈正相关(P<0.05);多元回归分析显示三酰甘油是影响AOPP的独立危险因素;BMI是影响MDA的独立危险因素;(2)透后AOPP较透前明显升高(P<0.05),透后MDA较透前也有升高,但差异无统计学意义;(3)应用黄芪注射液后透析前后AOPP差值较未用药时明显减少(P<0.05)。结论:(1)维持性血透患者氧化应激状态与营养不良、脂代谢紊乱、透析充分性相关,其中三酰甘油、BMI是影响氧化应激的独立危险因素;(2)透析过程能加重氧化应激状态;(3)滴注黄芪注射液能部分改善透析过程中的氧化应激状态。

Objective： To study the influencing factors of oxidative stress state in maintenance hemodialysis patients （ MHD）, and explore the impact of one - time Astragalus Root injecting on oxidative stress state during hemodialysis. Methods： Fifty -four MHD patients were enrolled in this research. Testing indicators include anthropometric measurement, blood biochemical pa- rameters, dialysis adequacy（eKt/V） and oxidative stress indicators （advanced oxidation protein products （AOPP）, malondialdehyde （MDA） ）. At the same time, the plasma levels of oxidative stress indicators were detected pre - dialysis and post - dialysis after the infusion of Astragalus Root Injection. Results ： （ 1 ） There were different correlation associations of AOPP, MDA and dry weight, Tri- ceps skinfold thickness, body mass index, albumin, triglyceride, high density lipoprotein, low density lipoprotein, eKt/V; （2） The levels of AOPP in post - dialysis were significantly higher than pre - dialysis, the levels of MDA in post - dialysis were higher than pre - dialysis, but the differences were not significant; （3） Through the use of Astragalus Root Injection during hemodialysis, the differ- ences of AOPP from hemodialysis were decreased. Conclusion： （ 1 ） Oxidative stress state in MHD patients are closely related with protein - energy malnutrition, lipid metabolism disorder and dialysis adequacy; （2） Hemodialysis can increase oxidative stress state ; （3） Infusion of Astragalus Root Injection during hemodialysis can partly improve the process of oxidative stress state.