CAJ | 학술논문

目的观察维生素 C 透析液对维持性血液透析(MHD)静脉补铁患者的微炎症因子 hs-CRP、TNF-a、IL-6、MDA、GHS-px 等表达的影响,探讨其抗氧化应激反应的作用.方法选择病情稳定、透析时间3个月以上、静脉补铁纠正贫血的 MHD 患者52例,按随机数字表法分为常规透析液组(A 组)和维生素 C 透析液组(B 组),每组26例.共进行3次血 hs-CRP、TNF-a、IL-6、MDA、GHS-px 因子的测定,第1次为补铁前,第2次为补铁第5周,第3次为补铁第7周.结果两组患者在补铁前各项微炎症因子的差异无统计学意义(P >0.05).补铁第5周,两组患者 hs-CRP、TNF-a、GSH-px 因子的差异有统计学意义(P<0.01),IL-6、MDA 因子差异有统计学意义(P<0.05).补铁第7周,两组患者 TNF-a、IL-6、MDA、GHS-px 因子的差异有统计学意义(P<0.01),而hs-CRP 因子的差异无统计学意义(P >0.05);两组患者均未见恶心、呕吐、过敏和腹泻等不良反应.结论静脉补铁可诱发微炎症反应,加重氧化应激反应,使用维生素 C 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.
목적관찰유생소 C 투석액대유지성혈액투석(MHD)정맥보철환자적미염증인자 hs-CRP、TNF-a、IL-6、MDA、GHS-px 등표체적영향,탐토기항양화응격반응적작용.방법선택병정은정、투석시간3개월이상、정맥보철규정빈혈적 MHD 환자52례,안수궤수자표법분위상규투석액조(A 조)화유생소 C 투석액조(B 조),매조26례.공진행3차혈 hs-CRP、TNF-a、IL-6、MDA、GHS-px 인자적측정,제1차위보철전,제2차위보철제5주,제3차위보철제7주.결과량조환자재보철전각항미염증인자적차이무통계학의의(P >0.05).보철제5주,량조환자 hs-CRP、TNF-a、GSH-px 인자적차이유통계학의의(P<0.01),IL-6、MDA 인자차이유통계학의의(P<0.05).보철제7주,량조환자 TNF-a、IL-6、MDA、GHS-px 인자적차이유통계학의의(P<0.01),이hs-CRP 인자적차이무통계학의의(P >0.05);량조환자균미견악심、구토、과민화복사등불량반응.결론정맥보철가유발미염증반응,가중양화응격반응,사용유생소 C 투석액가명현개선정맥보철 MHD 환자적미염증화양화응격반응.
@@@@Objective To investigate effect of ascorbic acid dialysate on oxidative stress and microinflammation induced by intravenous iron administration in patients with maintenance hemodialysis (MHD). Methods Forty-eight MHD patients with intravenous iron administration for >3m were randomly assigned to use regular dialysate (group A, n=24) or ascorbic acid dialysate (group B, n=24). The serum hypersensitive C reactive protein(hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), malon-dialdehyde (MDA) and glutathione peroxidase (GHS-px) were measured before 5 and 7 weeks after iron adminis-tration. Results There was no significant difference in the inflammatory factors before iron administration between two groups. The serum TNF-a, GSH-px, IL-6 and MDA levels were lower in group B than those in group A 5 and 7 weeks after iron adminis-tration (P<0.01 or 0.05); how the lower hs-CRP level only detected in group B at 5 weeks after iron administration (P<0.01). No side effects including nausea, vomiting, hypersensitivity or diarrhea were observed in both groups. Conclusion Intravenous iron administration can induce microinflammatory reaction and oxidative stress, which may be attenuated by using ascorbic acid dialysate in MHD patients.