中国血液净化

›› 2007, Vol. 6 ›› Issue (8): 422-424.

• 论著 • 上一篇    下一篇

维持性血液透析患者透析前后氧化应激变化与透析前后血压变化的关系

苏白海 李 孜 付 平 米绪华 樊均明 陶 冶   

  1. 610041 成都，四川大学华西医院肾脏内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2007-08-12 发布日期:2007-08-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2007-08-12 Published:2007-08-12

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摘要： 目的 本文探讨维持性血液透析患者透析前后机体氧化应激的变化与血压变化的关系。方法 选取四川大学华西医院肾脏内科30例维持性血液透析患者，检测单次血液透析前后血浆中氧化活性产物丙二醛(MDA)和抗氧化活性酶超氧物歧化酶(SOD)、谷光甘肽过氧化物酶(GSHPx)以及一氧化氮(NO)水平并记录患者单次血液透析前后的血压水平。结果 维持性血液透析患者透析后与透析前比较，血浆MDA水平明显增高(P＜0.01)，NO水平明显降低(P＜0.01)；透析后血浆抗氧化酶SOD、GSHPx水平也较透析前有不同程度的增高。20例患者透析后血压(包括收缩压和舒张压)较透析前明显增高，2例患者发生透析后低血压,其余8例患者透析前后血压差异无显著性。相关性分析发现，15例患者透析前高血压的(血压＞140/90mmHg)(1mm Hg=0.133kpa)维持性血液透析患者的透析前后血压变化差值水平与血浆MDA水平呈正相关(r = 0.462,P＜0.01)，而与血浆NO水平呈负相关(r=-0.483,P＜0.01)。结论 维持性血液透析患者透析后血浆MDA和NO水平变化与患者透析后的血压升高具有明显的相关关系，透析后机体氧化应激的变化可能是透析后高血压新的发生机制，抗氧化应激可能为防治透析后高血压的发生提供新的思路。

关键词: 血液透析, 氧化应激, 透析后高血压

Abstract: Objective To reveal the relationship between the changes of oxidative stress and hypertension before and after dialysis in maintenance hemodialysis patients. Methods Thirty maintenance hemodialysis patients were selected. Blood pressure and serum levels of oxidative product malondialdehyde (MDA) and anti-oxidative products including superoxide dismutase (SOD), glutathione peroxidase (GSHPx) and nitric oxide (NO) were measured before and after hemodialysis. Results Serum MDA elevated markedly and NO lowered markedly after dialysis, as compared with those before dialysis (P＜0.01). Serum SOD and GSHPx were increased, as compared with those before dialysis. Systolic and diastolic blood pressure elevated in 20 patients after dialysis, decreased in 2 patients and had no remarkable changes in the remaining 8 patients. Correlation analysis revealed a positive correlation between serum MDA level and blood pressure (r = 0.462 for systolic blood pressure, P＜0.01) and a negative correlation between serum NO level and blood pressure (r = -0.483 for systolic blood pressure, P＜0.01). Conclusion Changes of serum MDA and NO have a close correlation to the elevation of blood pressure after hemodialysis in maintenance hemodialysis patients. Change of oxidative stress after dialysis may contribute as a new factor to post-dialytic hepertension. Anti-oxidative therapy may be useful for the prevention of post-dialytic hepertension.

Key words: Oxidative stress, Post-dialytic hypertension

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