【摘要】 目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者氧化应激(oxidative stress,OS)、微炎症状态(micro-inflammatory state,MIS)指标与透析时间的关系。方法选择2012年12月在南通市第三人民医院血液净化中心稳定血液透析治疗3个月以上的慢性肾衰竭患者144例作为维持性血液透析组(MHD组),根据透析时间不同分为4个亚组:MHD-1亚组45例,透析时间3~24个月;MHD-2亚组41例,透析时间25~60个月;MHD-3亚组37例,透析时间61~120个月;MHD-4亚组21例,透析时间>120个月。另选择健康体检者29名为对照组。入选对象均清晨空腹取外周静脉血标本。采用酶联免疫吸附法检测血清晚期氧化蛋白产物(advanced oxidation protein products,AOPP)、白细胞介素6(interleukin-6,IL-6)与肿瘤坏死因子α(tumor necrosis factor-α,TNF-α),散射比浊法测定血清C反应蛋白(C-reactive protein,CRP)。采用单因素方差分析、t检验、Pearson相关分析比较MHD组与对照组各指标及其与透析时间的相关性。结果①MHD各亚组患者血清AOPP水平均明显高于对照组(P<0.05);②MHD各亚组患者血清CRP水平明显高于对照组(P<0.05),IL-6、TNF-α在透析治疗24个月后与对照组比较差异有统计学意义(P<0.05);③AOPP与CRP、IL-6、TNF-α呈正相关(r=0.810,P<0.01;r=0.876,P<0.01;r=0.919,P<0.01);④AOPP、CRP、IL-6、TNF-α与透析时间均呈正相关(r=0.823,P<0.01;r=0.894,P<0.01;r=0.940,P<0.01;r=0.929,P<0.01)。结论 MHD患者体内存在明显的氧化应激和微炎症状态,二者关系密切,且均随透析时间延长而呈逐渐加重趋势。更多还原

【Abstract】 Objective To explore the relationship between hemodialysis age and the markers of oxidative stress and micro-inflammatory state in maintenance hemodialysis(MHD) patients.Methods 144 MHD patients(MHD group) and 29 normal cases(control group) were enrolled.According to hemodialysis age,MHD group was divided into four subgroups:MHD-1 subgroup(n=45,hemodialysis age of 3~24 months);MHD-2 subgroup(n=41,hemodialysis age of 25~60 months);MHD-3 subgroup(n=37,hemodialysis age of 61~120 months),and MHD-4 subgroup(n=21,hemodialysis age of over 120 months).Serum AOPP,IL-6,TNF-α and CRP levels were measured.The relationship between the markers of oxidative stress and micro-inflammatory state,and the relationship between all these markers and hemodialysis age were analyzed.Statistical analysis was conducted with one-way ANOVA,t test and pearson’s correlation.Results(1)Serum AOPP in MHD patients was significantly higher than in controls(P<0.05);(2)Serum CRP in MHD patients was significantly higher than in controls too(P<0.05),and IL-6 and TNF-α levels in MHD-2-4 subgroups were significantly higher than those in controls(P<0.05);(3) AOPP was positively correlated with CRP,IL-6,and TNF-α(P<0.01);(4) AOPP and CRP,IL-6,TNF-α in MHD patients were positively correlated to their hemodialysis age(P<0.01).Conclusions There are oxidative stress and micro-inflammatory states in MHD patients.There is a intimate relationship between oxidative stress and micro-inflammation in MHD patients.With hemodialysis age prolonged,the levels of oxidative stress and micro-inflammation in MHD patients became more severer.更多还原