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目的研究抗氧化剂维生素E对维持性血液透析(MHD)患者氧化应激及微炎症状态的影响。方法选择2005年1月至2006年3月在重庆医科大学第二附属医院血液净化中心透析时间超过3个月的MHD患者58例,口服维生素E400mg/d,服药6周,观察用药前后血浆中维生素E及血浆丙二醛(MDA)、循环晚期氧化蛋白产物(AOPP)、过氧化物歧化酶(SOD)、谷胱苷肽过氧化物酶(GSH-PX)等氧化指标以及血浆高敏C-反应蛋白、白介素-6(IL-6)、白介素10(IL-10)、肿瘤坏死因子-α(TNF-α)等炎症指标的变化。选择20名健康者作对照组。结果给予维生素E治疗后,患者MDA、AOPP较治疗前明显降低(P<0.01),维生素E、SOD活性、GSH-PX活性较治疗前升高(P<0.01),炎症指标CRP和TNF-α较治疗前明显降低(P<0.01),IL-6变化较治疗前差异无显著性。结论口服大剂量维生素E(400mg/d)可以改善血液透析患者的氧化应激状态并具有抗炎效应,短期应用大剂量维生素E未见明显副反应。
Objective To investigate the effect of antioxidant vitamin E on oxidative stress and microinflammatory state in maintenance hemodialysis (MHD) patients. Methods From January 2005 to March 2006, 58 MHD patients with dialysis duration of more than 3 months in the Second Affiliated Hospital of Chongqing Medical University Blood Purification Center were enrolled in this study. Vitamin E 400 mg / d was orally administered for 6 weeks. The levels of vitamins E and oxidative indexes such as plasma MDA, AOPP, SOD, GSH-PX and plasma hypersensitivity C-reaction (IL-6), interleukin 10 (IL-10) and tumor necrosis factor-α (TNF-α) were detected by ELISA. Choose 20 healthy people as control group. Results After treatment with vitamin E, the levels of MDA and AOPP in patients were significantly lower than those before treatment (P <0.01). The activity of vitamin E, SOD and the activity of GSH-PX were increased (P <0.01) Compared with before treatment was significantly lower (P <0.01), IL-6 changes than before treatment no significant difference. Conclusion Oral administration of high dose of vitamin E (400mg / d) can improve oxidative stress status and anti-inflammatory effect in hemodialysis patients. No obvious adverse reactions were observed in short-term high-dose vitamin E treatment.