中国血液净化

›› 2002, Vol. 1 ›› Issue (12): 7-11.

• 论著 • 上一篇    下一篇

慢性肾衰竭血清晚期糖基化终产物水平的变化及意义

赵慧萍 徐学明   

  1. 100044 北京，北京大学人民医院肾内科(赵慧萍) 130021 白求恩医科大学第一临床学院肾内科(徐学明)
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2002-12-19 发布日期:2002-12-19

  • Received:1900-01-01 Revised:1900-01-01 Online:2002-12-19 Published:2002-12-19

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摘要： 【摘要】目的 探讨慢性肾功能衰竭患者血清晚期糖基化终产物（AGEs）水平的变化、意义及高通量血透对AGEs的清除效果。方法 应用竞争性ELISA法检测慢性肾功能衰竭（CRF）患者（非血液透析组及血液透析组）血清AGEs 水平，同时测血浆脂质过氧化物丙二醛（MDA）含量及超氧化物歧化酶（SOD）活性。结果 CRF患者无论血液透析与否，血清AGEs均明显高于健康组（P均<0.001），非血液透析与血液透析组AGEs水平无显著性差异（P<0.05），AGEs水平与CRE呈明显正相关（r=0.5974，P<0.01），与血糖无相关性；CRF患者血浆MDA含量明显高于健康组（P均<0.001），SOD活性明显低于健康组（P<0.05）。AGEs与MDA、SOD间无相关性；常规血液透析（CHD）组，透析前后血清AGEs水平无显著性差异（P < 0.05），而高通量血液透析（HFHD）组透析后血清AGEs水平明显降低（P<0.001），两组血浆SOD活性均明显升高（X P<0.01），MDA含量明显降低（P<0.01）。结论 CRF时，因肾功能受损致AGEs清除障碍，是血清AGEs水平升高的主要原因，同时CRF时氧化应激增强可能也促进了AGEs生成。高通量血液透析可以有效清除血清AGEs，并改善自由基代谢紊乱。

关键词: 晚期糖基化终产物, 慢性肾功能衰竭, 氧化应激, 高通量血液透析

Abstract:

【Abstract】Objective To evaluate the changes and significance of serum advanced glycosylation end products (ACEs)in patients with chronic renal failure(CRF), and the clearance effect of High-Flux HD to AGEs. Methods The serum AGEs in patients with CRF(Hemodialysis group and Non-Hemodialysis group) were measured by using competitive ELISA. The MDA contents and SOD activities in plasma were also examined. Results Whether HD or not, the serum AGEs levels in patients with CRF were significantly higher than those in normal subjects (both P<0.001). No significant differences were found between the serum AGEs levels in HD group patients and those in NHD group (P>0.05). A significantly positive correlation was found between the serum AGEs levels and serum CRE values (P < 0.01)，no correlation was found between the serum AGEs levels and serum GLU values; The plasma SOD activities in CRF patients were significantly lower than those in healthy subjects (in every group: P<0.05). The plasma MDA contents in every group were significantly higher than those in healthy subjects (P<0.001). No correlation was found between AGEs and MDA、SOD ( P>0.05); In CHD (Convention HD) group, there was no significantly difference before and after CHD (P>0.05), while in HFHD(high flux HD) group, the serum AGEs levels significantly decreased after HFHD(P<0.001). In both groups, the plasma SOD activities significantly increased and the plasma MDA contents significantly decreased (both P<0.01). Conclusion In CRF patients, impaired renal function decreased the clearance of AGEs, the impaired renal function could be the most important factor to make AGEs higher. And the strengthened oxidative stress could have accelerated the formation of AGEs. High- flux HD can clear the serum AGEs efficiently, and alleviate the disorders of free radicals metabolism.

Key words: Chronic renal failure, Oxidative stress, High-flux Hemodialysis