中国血液净化

中国血液净化 ›› 2019, Vol. 18 ›› Issue (11): 745-749.doi: 10.3969/j.issn.1671-4091.2019.11.004

• 临床研究 • 上一篇    下一篇

不同剂量静脉补铁对维持性血液透析患者炎症反应及氧化应激的影响

戴珊珊1,徐俊1,马迎春1   

  1. 1. 首都医科大学康复医学院，中国康复研究中心北京博爱医院肾内科
  • 收稿日期:2019-08-26 修回日期:2019-08-29 出版日期:2019-11-12 发布日期:2019-10-28
  • 通讯作者: 马迎春 mych323@163.com
  • 基金资助:
    中国康复研究中心课题2016ZX-18

Effects of different doses of intravenous iron supplement on inflammatory response and oxidative stress in maintenance hemodialysis patients#br#

  1. 1Department of Nephrology,Beijing Bo’ai Hospital, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital
    Medical University, Beijing 100068, China
  • Received:2019-08-26 Revised:2019-08-29 Online:2019-11-12 Published:2019-10-28

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摘要：

【摘要】目的比较不同剂量静脉补铁方案对存在持续性铁丢失的维持性血液透析(maintenance of hemodialysis，MHD)患者炎症反应及氧化应激水平的影响。方法入选中国康复研究中心北京博爱医院血液透析中心，血清铁蛋白200～500ng/ml 的MHD 患者共55 例，随机分为A 组(蔗糖铁100mg/周×10 次，400mg/月)与B 组(100mg/2 周×10 次，200mg/月)，2 组患者补充蔗糖铁总量均为1000mg，比较2 组在治疗前及治疗后1 周、2 周、4 周、6 周、8 周、12 周炎症及氧化应激指标的变化，包括超敏C 反应蛋白(hypersensitive C-reactive protein，hsCRP)、血清超氧化物歧化酶(superoxide dismutase，SOD)、白细胞介素-6(interleukin-6，IL-6)、肿瘤坏死因子α(tumor necrosis factor-α，TNF-α)、谷胱甘肽过氧化物酶(glutathione peroxidase-px，GSH-px)。结果各项炎症及氧化应激指标hsCRP(F=2.161，P=0.067)、SOD(F=1.858，P=0.113)、IL- 6(F=1.667，P=0.157)、TNF- α(F=1.433，P= 0.229)、GSH- px (F=2.161，P=0.067)在治疗前后不同时间点的变化无统计学差异；2 组患者之间各项炎症及氧化应激指标hsCRP (F=2.179, P=0.065)、SOD(F=0.477, P=0.821)、IL- 6(F=0.853, P=0.538)、TNF- α(F=0.761, P=0.605)、GSH-px(F=0.720, P=0.636)的比较也无统计学差异；治疗期间2 组患者血红蛋白变异系数(t=-0.983，P=0.330)、治疗前后重组人红细胞生成素(recombinant human erythropoietin，rHuEPO)用量的变化(Z=-0.139，P=0.889)、转铁蛋白饱和度(t=0.536，P=0.594)及血清铁蛋白(t=-0.161，P=0.873)的变化在2 组之间均无统计学差异。结论静脉铁剂200mg/月与400mg/月2 种治疗方案对MHD 患者炎症及氧化应激的影响并无差异，2 组患者在铁代谢指标、血红蛋白及rHuEPO用量变化等方面基本相似。

关键词: 维持性血液透析, 静脉铁剂, 炎症反应, 氧化应激

Abstract:

【Abstract】Objective To compare the effects of different doses of intravenous iron supplement on inflammatory response and oxidative stress in maintenance hemodialysis (MHD) patients with persistent iron loss. Method A total of 55 MHD patients with serum ferritin 200-500 ng/ml from the Hemodialysis Center of Beijing BOAI Hospital were randomly divided into group A (sucrose iron 100mg/week×10 times, 400mg/month) and group B. (100mg/2 weeks × 10 times, 200mg/month). The total amount of sucrose iron was 1,000mg in both groups. The changes of inflammatory response and oxidative stress indicators including hypersensitive C-reactive protein (hsCRP), serum superoxide dismutase (SOD), interleukin-6 (IL-6), tumor necrosis
factor alpha (TNF-α) and glutathione peroxidase (GSH-px) were compared before treatment and after the treatment for 1, 2, 4, 6, 8 and 12 weeks between the two groups. Result There were no significant differences in hsCRP (F=2.161, P=0.067), SOD (F=1.858, P=0.113), IL-6 (F=1.667, P=0.157), TNF-α (F=1.433, P=0.229) and GSH-px (F=2.161, P=0.067) before treatment and at different time points after treatment. There were no significant differences in hsCRP (F=2.179, P=0.065), SOD (F=0.477, P=0.821), IL- 6 (F=0.853, P=0.538), TNF-α (F=0.761, P=0.605) and GSH-px (F=0.720, P=0.636) between the two groups. The coefficient of hemoglobin variation during the treatment period (t=-0.983, P=0.330), and the changes of recombinant human erythropoietin doses (Z=- 0.139, P=0.889), transferrin saturation (t=0.536, P=0.594) and serum ferritin (t=-0.161, P=0.873) before and after the treatment had no statistical differences between the two groups. Conclusion There were no differences in the effects on inflammatory response and oxidative stress in MHD patients treated with intravenous iron 200mg/month and 400mg/month. The two iron therapeutic methods had equal effects for anemia treatment in MHD patients.

Key words: Maintenance hemodialysis, Intravenous iron supplement, Inflammatory response, Oxidative stress

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