CAJ | 학술논문

目的：探讨硫辛酸对腹膜透析患者氧化应激、炎症及营养状况的影响。方法：以腹膜透析患者为研究对象，随机分成观察组47例和对照组47例，两组均给予相同的常规治疗，观察组予硫辛酸胶囊（一次0．2g，一日3次）口服，疗程为12周。检测超氧化物歧化酶（SOD）、丙二醛（MDA）、血清晚期蛋白氧化产物（AOPPs）反映氧化应激水平，检测超敏CRP、IL－6和TNF－α反映微炎症状态，使用改良定量主观整体评估（ MQSGA）、中臂围、中臂肌围、肱三头肌皮褶厚度（ TSF）、体重指数（ BMI）和血白蛋白反映营养状况。比较两组治疗前和治疗后氧化应激、微炎症状态和营养状况的差别。结果：①观察组治疗后AOPPs和MDA均显著低于治疗前，SOD显著高于治疗前，差异均有统计学意义（ P＜0．05）；治疗后，观察组AOPPs和MDA均显著低于对照组，SOD显著高于对照组，差异均有统计学意义（ P＜0．05）；②观察组治疗后超敏CRP、IL－6和TNF－α均显著低于治疗前，差异均有统计学意义（P＜0．05）；治疗后，观察组超敏CRP、IL－6和TNF－α均显著低于对照组，差异均有统计学意义（P＜0．05）；③观察组治疗后TSF、中臂围、中臂肌围、BMI和白蛋白均较治疗前显著升高，MQSGA较治疗前显著下降，差异均有统计学意义（ P＜0．05）；治疗后，观察组MQSGA显著低于对照组，白蛋白显著高于对照组，差异均有统计学意义（ P＜0．05）。结论：硫辛酸可改善腹膜透析患者的氧化应激，从而改善微炎症状态和营养状况。
목적：탐토류신산대복막투석환자양화응격、염증급영양상황적영향。방법：이복막투석환자위연구대상，수궤분성관찰조47례화대조조47례，량조균급여상동적상규치료，관찰조여류신산효낭（일차0．2g，일일3차）구복，료정위12주。검측초양화물기화매（SOD）、병이철（MDA）、혈청만기단백양화산물（AOPPs）반영양화응격수평，검측초민CRP、IL－6화TNF－α반영미염증상태，사용개량정량주관정체평고（ MQSGA）、중비위、중비기위、굉삼두기피습후도（ TSF）、체중지수（ BMI）화혈백단백반영영양상황。비교량조치료전화치료후양화응격、미염증상태화영양상황적차별。결과：①관찰조치료후AOPPs화MDA균현저저우치료전，SOD현저고우치료전，차이균유통계학의의（ P＜0．05）；치료후，관찰조AOPPs화MDA균현저저우대조조，SOD현저고우대조조，차이균유통계학의의（ P＜0．05）；②관찰조치료후초민CRP、IL－6화TNF－α균현저저우치료전，차이균유통계학의의（P＜0．05）；치료후，관찰조초민CRP、IL－6화TNF－α균현저저우대조조，차이균유통계학의의（P＜0．05）；③관찰조치료후TSF、중비위、중비기위、BMI화백단백균교치료전현저승고，MQSGA교치료전현저하강，차이균유통계학의의（ P＜0．05）；치료후，관찰조MQSGA현저저우대조조，백단백현저고우대조조，차이균유통계학의의（ P＜0．05）。결론：류신산가개선복막투석환자적양화응격，종이개선미염증상태화영양상황。
Objective:To explore the effect of lipoic acid on oxidative stress,inflammation and nutritional status in peritoneal dialysis patients.Methods:94 peritoneal dialysis patients were randomly divided into the observe group(n=47) the control group(n=47).They all accepted the conventional treatment,but the patients in the observed group were given the treatment of lipoic acid capsules(0.2 g tid) for 12 weeks.Superoxide dismutase(SOD),malondialdehyde(MDA),serum advanced oxidation protein products ( AOPPs ) were used to reflect the level of oxidative stress, high sensitive CRP, IL-6 and TNF-αwere used to reflect the micro inflammatory state, modified quantitative subjective global assessment ( MQSGA ) , mid-arm circumference, mid-arm muscle circumference,triceps skinfold thickness ( TSF ) , body mass index ( BMI ) , and serum albumin were used to reflect the nutritional status.The difference of oxidative stress, micro inflammatory state and nutritional status were compared between the two groups.Results:①In the observation group,the concentrations of AOPPs and MDA after treatment were significantly lower than that before treatment,and the concentration of SOD after treatment was significantly higher than that before treatment ( P<0.05 );after treatment,the concentrations of AOPPs and MDA in the observe group were significantly lower than that in the control group(P<0.05), and the concentration of SOD in the observe group was significantly higher than that in the control group ( P<0.05 ) .②In the observation group,the concentrations of high sensitive CRP,IL-6 and TNF-αafter treatment were significantly lower than that before treatment(P<0.05);after treatment,the concentrations of high sensitive CRP,IL-6 and TNF-αin the observe group were significantly lower than that in the control group ( P<0.05 ) .③In the observation group, the TSF, mid-arm circumference, mid-arm muscle circumference,BMI and albumin after treatment were significantly higher than that before treatment(P<0.05),and the MQSGA after treatment was significantly lower than that before treatment ( P<0.05 );after treatment, the MQSGA in the observe group was significantly lower than that in the control group(P<0.05),and serum albumin in the observe group was significantly higher than that in the control group(P<0.05).Conclusion:Lipoic acid could improve oxidative stress in peritoneal dialysis patients,so as to improve the micro inflammatory state and nutritional status.