中国血液净化

›› 2011, Vol. 10 ›› Issue (3): 129-132.doi: 10.3969/j.issn.1671-4091.2011.03.00

• 临床研究 • 上一篇    下一篇

慢性肾脏病患者低分子肝素抗氧化作用的研究

刘晓燕 钟一红 丁小强   

  1. 复旦大学附属中山医院肾内科, 大连医科大学附属第二医院肾内科
  • 收稿日期:2010-09-06 修回日期:1900-01-01 出版日期:2011-03-12 发布日期:2011-03-12
  • 通讯作者: 丁小强

The effect of low molecular weight heparin as an antioxidant in chronic kidney disease

LIU Xiao-yan, ZHONG Yi-hong, DING Xiao-qiang   

  1. 1Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 2Department of Nephrology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China
  • Received:2010-09-06 Revised:1900-01-01 Online:2011-03-12 Published:2011-03-12

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摘要： 【摘要】 目的 阐明在慢性肾脏病(chronic kidney disease,CKD)时低分子肝素是否具有抗氧化作用，为临床治疗提供理论依据。 方法 选取CKD 3～5期住院患者40例，随机分为低分子肝素(low molecular weight heparin，LMWH)组(速碧林0.4 ml/d皮下注射，连续10 d)及还原型谷胱甘肽(reduced glutathione，GSH)组(泰特1.8 g/d加入0.9% NaCl溶液静脉滴注，连续10 d)。测定2组用药前后血浆氧化应激指标谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-PX)、丙二醛(malondialdehyde,MDA)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)，并观察药物不良反应。 结果 LMWH及GSH治疗后血浆AOPP水平均显著降低(P＜0.05)，GSH组AOPP降低值显著高于LMWH组，分别为(4.89±0.66)靘ol/L和(2.86±0.82)靘ol/L，差异有统计学意义(P＜0.05)；LMWH及GSH治疗后GSH-PX活力均显著升高(P＜0.05),LMWH组和GSH组GSH-PX升高值分别为(3.55±1.01)×104 U/L和(4.77±1.78)×104 U/L，差异无统计学意义(P＞0.05)；LMWH治疗前后MDA分别为(5.54±1.66)nmol/ml和(5.42± 1.40)nmol/ml，差异无统计学意义(P＞0.05)，GSH治疗后MDA活力比治疗前显著降低，分别为(5.09±1.44)nmol/ml和(4.61±1.30)nmol/ml，差异有统计学意义(P＜0.05)。两组药物治疗期间均未见明显不良事件。 结论 LMWH可以改善CKD患者氧化应激状态，短期应用未见明显不良反应。与GSH相比，LMWH的抗氧化作用稍弱。

关键词: 氧化应激, 慢性肾脏病, 低分子肝素, 还原型谷胱甘肽

Abstract: Objective To identify the anti-oxidative effect of low molecular weight heparin (LMWH) in chronic kidney disease (CKD). Method Forty CKD patients at stage 3-5 were randomly divided into two groups, glutathione (GSH) group (0.9% NaCl 250ml + Glutathione 1.8g/d, intravenous injection for 10 days) and LMWH group (Fraxiparine 0.4ml/d, subcutaneous injection for 10 days). Plasma malondialdehyde (MDA), advanced oxidation protein product (AOPP) and glutathione peroxidase activity (GSH-PX) were measured at the beginning and the end of glutathione or LMWH administration. Results Plasma AOPP decreased and plasma GSH-PX increased significantly after the treatment in both LMWH and GSH groups (P<0.05). The decrease of plasma AOPP was more significant in GSH group than in LMWH group (2.86±0.82 vs. 4.89±0.66μmol/l, P<0.05). After the treatment, plasma MDA did not change significantly in LMWH group, but decreased (5.09±1.44 vs. 4.61±1.30nmol/ml, P<0.05) in GSH group. There were no apparent side effects in both groups. Conclusion LMWH ameliorates oxidative stress state without apparent side effects. The anti-oxidative effect of LMWH is slightly lower than that of GSH.

Key words: Chronic kidney disease, Low molecular weight heparin, Reduced glutathione