绿茶提取物EGCG对维持性血液透析患者氧化应激与营养状况的影响

Effects of EGCG on Oxidative Stress and Nutritional Status in Patients with Maintenance Hemodialysis

目的:探讨绿茶提取物EGCG[(-)-epigallocatechin-3-gallat,EGCG,表没食子儿茶素-3-没食子酸酯]对血液透析患者氧化应激以及对营养状况的影响。方法:选择2011年04月~2016年08月两家血液透析中心维持性血液透析3月,符合入选条件的159例患者随机分为3组(n=53)。A组为低剂量组,B组为大剂量组,C组为对照组。实验前收集3组患者可溶性晚期糖基化终产物受体(soluble receptor for advanced glycation end products,sRAGE)、EN-RAGE(RAGEbinding protein,S100A12)以及转铁蛋白、白蛋白、β2-微球蛋白、瘦素、标准化蛋白分解率(normalized protein catabolic rate,nPCR)、铁调素、iPTH。A组每日给予绿茶提取物(EGCG)1 g口服,B组每日给予EGCG 2 g口服。半年后重复检测上述指标并进行统计处理(方差分析和配对T检验)。结果:半年后3组患者之间sRAGE、EN-RAGE以及转铁蛋白、白蛋白、β2-微球蛋白、瘦素、nPCR、铁调素存在显著差异(P<0.05)。对治疗前后的差值进行比较显示:C组sRAGE和EN-RAGEA明显高于A组,A组高于B组;B组转铁蛋白、白蛋白和nPCR明显高于A组,A组高于C组;C组瘦素、铁调素明显高于A组,A组高于B组;C组β2-微球蛋白高于B组;iPTH无差异(P>0.05)。结论:EGCG有可能抑制血液透析患者的氧化应激,改善营养状况,特别是大剂量使用时。

Objective： To evaluate the effect of EGCG（-epigallocatechin-3-gallate） on oxidative stress and nutritional status in maintenance hemodialysis（MHD） patients. Methods： One hundred and fifty-nine maintenance hemodialesis（MHD） patients were involved in this study. The MHD patients who had undergone hemodialysis for three months and without signs of infection and heart failure were randomly divided into low dose group（group A）,large dose group（group B） and control group（group C）.Patients in A group and group B took EGCG at dose of one and two gram per day for six months. Serum obtained from three groups were measured for sRAGE,EN-RAGE,transferring,albumin,β2-MG,leptin,nPCR,hepcidin and iPTH before and after six months. Results： After 6 months of intervention,significant differences were observed in levels of sRAGE,EN-RAGE,transferring,albumin,β2-MG,leptin,nPCR,hepcidin among three groups（P〈0. 05）; However,no significant changes was seen in i PTH in three groups（P〈0. 05）. Serum levels of transferring,albumin,nPCR were the highest in B group and higher in A group. Serum levels of s RAGE,EN-RAGE,β2-MG,leptin and hepcidin were in contrast. Conclusion： This study shows that EGCG may be an effective complementary supplement for reducing the severity of malnutrition in HD patients through alleviating oxidative stress,especially in large dose.