中国血液净化

›› 2004, Vol. 3 ›› Issue (8): 426-430.

• 论著 • 上一篇    下一篇

尿毒症患者肾性贫血对氧化应激的影响

张 新 彭立人 赵素梅   

  1. 100020 北京，首都医科大学附属北京朝阳医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-08-12 发布日期:2004-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-08-12 Published:2004-08-12

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摘要：

目的 通过测定不同贫血程度尿毒症患者外周血脂质过氧化物（LPO）和红细胞中超氧化物歧 化酶（SOD）的活性变化，来检测尿毒症患者氧化应激情况及探讨肾性贫血对氧化应激的影响。方法 将血液透析患者分为2组，组I患者未经正规红细胞生成素（rHuEPO）治疗血红蛋白(Hb)浓度<10g/L，组II患者经正规rHuEPO治疗6个月后Hb>10g/L。应用硫代巴比妥酸比色法(TBAR)分别检测2组患者血液透析前血浆LPO浓度，及应用邻苯三酚法检测2组患者红细胞SOD值，同时检测血生化指标：尿素氮，肌酐，白蛋白，胆固醇，低密度脂蛋白等。结果 组I Hb浓度与组II Hb有显著差异 (P<0.001),而血生化指标无明显差异(P>0.05)。治疗后两组血 LPO浓度有显著性差异 (P<0.001)，且均明显大于健康对照组(P<0.001), 两组红细胞 SOD浓度有显著性差异 (P=0.002)，且均明显低于对照组（P=0.005）。LPO值与Hb浓度呈反相关(r=-0.680, P<0.001)。红细胞 SOD浓度与Hb浓度呈正相关 (r=0.449，P = 0.01)。结论 尿毒症患者脂质过氧化物较正常人增高，而抗氧化物较正常人减少，证明尿毒症患者氧化应激增加。组 I患者血红蛋白明显低于组II患者，证明贫血越严重，氧化应激越增强，氧化应激与贫血成正相关，提示贫血会加重氧化应激，积极纠正贫血可改善尿毒症患者的氧化应激状态。

关键词: 尿毒症, 氧化应激, 肾性贫血

Abstract:

Objective The aim of the investigation is to examine oxidative stress of uremic patients and evaluate the role of renal anemia as a secondary cause of oxidative stress. Methods Lipid peroxidation (LPO) and superoxide dimutase(SOD) are measured in two groups of patients undergoing HD:group I comprises 12 patients with a blood haemoglobin(Hb)<10g/dl, and group II comprised 20 patients with a Hb>10g/dl after long-term human recombinant erythropoietin(rHuEpo) treatment. Results Plasma concentration of LPO is significantly higher (P<0.01) in all 32 HD patients than in healthy control, and SOD of HD patients is lower than health control (P=0.005). After treatment Hb concentration of group I is less than that of group II,after treatment patients of Group I has significantly higher plasma level of LPO than patients of Group II (P<0.001), SOD of Group patients I is significantly lower than that of Group II (P=0.001). An inverse correlation is seen for LPO and Hb (r=-0.680, P<0.001), a positive correlation is also seen for SOD and Hb (r=0.449, P=0.01). Conclusion The oxidative stress product of uremic patients is greater than that of the normal controls, which proves that the oxidative stress of uremia increase. Hb of group I is lower than that of group II,demonstrating that oxidative stress increases with the decrease of Hb concentration. There is a positive correlation between renal anemia and oxidative stress. Correcting renal anemia effiently is very effective to decrease the oxidative stress.

Key words: Oxidative stress, Renal anemia 

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