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目的:观察抗坏血酸透析液对维持性血透(MHD)静脉补铁患者的血超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血浆丙二醛(MDA)、谷光甘肽过物氧化酶(GHS-px)等因子表达的影响。方法:选择病情稳定、透析时间达3月以上、静脉补铁纠正贫血的MHD患者48例,随机分两组,一组为常规透析液组(A组),一组为抗坏血酸透析液组(B组),每组24例,样本一般情况差异无统计学意义。共进行3次血hs-CRP、TNF-α、IL-6、MDA、GSH-px因子的测定,第1次为首次补铁前,第2次为补铁5周,第3次为补铁7周。结果:两组在补铁前上述各项炎症因子差异无统计学意义;补铁5周后,两组之间hs-CRP、TNF-α、GSH-px因子差异有统计学意义(P<0.01),IL-6、MDA因子差异有统计学意义(P<0.05);补铁7周后,两组之间TNF-α、IL-6、MDA、GHS-px因子差异有统计学意义(P<0.01),hs-CRP因子差异无统计学意义;抗坏血酸透析液组未见恶心、呕吐、过敏和腹泻等表现。结论:静脉补铁可诱发微炎症反应及加重氧化应激反应,应用抗坏血酸透析液可明显改善静脉补铁MHD患者的微炎症和氧化应激反应。
OBJECTIVE: To observe the effects of ascorbate dialysate on the expression of hs-CRP, TNF-α and IL-6 in maintenance hemodialysis (MHD) 6), plasma malondialdehyde (MDA), glutathione peroxidase (GHS-px) and other factors. Methods: Forty-eight MHD patients with stable disease, dialysis time of more than 3 months and intravenous iron supplementation to correct anemia were randomly divided into two groups: one was a conventional dialysis fluid group (group A) and the other was ascorbate dialysis fluid group (B Group), each group of 24 cases, the general differences in the sample was not statistically significant. A total of three times of blood hs-CRP, TNF-α, IL-6, MDA, GSH-px determination, the first for the first iron supplementation, the second iron for 5 weeks, the third for iron 7 weeks. Results: There was no significant difference in the inflammatory factors between the two groups before iron supplementation. After 5 weeks of iron supplementation, the differences of hs-CRP, TNF-α and GSH-px between the two groups were statistically significant (P <0.01 (P <0.05). After 7 weeks of iron supplementation, the differences of TNF-α, IL-6, MDA and GHS-px between the two groups were statistically significant (P <0.01). There was no significant difference in hs-CRP between the two groups. There was no nausea, vomiting, allergy and diarrhea in the ascorbate dialysate group. Conclusion: Intravenous iron supplementation can induce microinflammatory reaction and aggravate oxidative stress. Application of ascorbate dialysate can significantly improve the microinflammation and oxidative stress response in intravenous iron-supplemented MHD patients.