| 摘要: |
| 目的:观察不同血液净化方式对维持性血液透析(MHD)患者体内晚期氧化蛋白产物(AOPP)的清除,及相应颈动脉内中膜厚度(IMT)和动脉粥样斑块的变化,探讨AOPP、血液净化方式与动脉粥样硬化之间的关系。方法:将72例尿毒症患者按不同血液净化方式分为:单纯血液透析(HD)组,血液透析联合血液滤过(HD+HDF)组,血液透析联合连续性肾脏替代治疗(HD+CRRT)组。检测单次HD、HDF和CRRT治疗对AOPP的清除能力,并在12个月治疗前后测定3组患者血清AOPP、IL-6、单核细胞趋化蛋白-1(MCP-1)、高敏C反应蛋白(hs-CRP)水平,及作颈动脉彩色多普勒超声检查,同时设健康对照组。结果:HD组患者血清AOPP、IL-6、MCP-1、hs-CRP水平明显高于健康对照组(P<0.001)；HD+CRRT组治疗后血清AOPP水平显著下降(HD 136.24 vs 212.01 μmol/L ,P<0.001；CRRT 118.76 vs 208.91 μmol/L,P<0.001)；治疗12个月后各组血液净化前血清AOPP水平比较,HD组升高(由196.24 μmol/L升至264.86 μmol/L,P<0.01),HD+HDF组和HD+CRRT组无显著差异; HD+HDF和HD+CRRT治疗的MHD患者12个月后颈动脉IMT低于HD治疗组(P<0.05),同时粥样硬化斑块的面积小于HD治疗组；Pearson检测显示MHD患者血清AOPP水平与颈动脉IMT、动脉粥样斑块面积呈显著正相关(r=0.79,r=0.67,P均<0.01)。结论:HD辅以HDF和CRRT治疗能显著清除AOPP,改善MHD患者动脉粥样硬化的发生及发展。 |
| 关键词: 肾透析 动脉硬化 晚期氧化蛋白产物 氧化应激 |
| DOI：10.3724/SP.J.1008.2008.01528 |
| 投稿时间：2008-05-09修订日期：2008-09-03 |
| 基金项目: |
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| Different modes of blood purification clear advanced oxidation protein products and influence atherosclerosis |
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| Abstract: |
| [Abstract] Objective To investigate the influence of different modes of blood purification treatment on atherosclerosis (AS) in patients with maintained hemodialysis(MHD) by measuring the serum levels of advanced oxidation protein products (AOPP) and the datas of carotid artery Methods 72 patients with MHD were assigned to receive the treatment of different modes of blood purification : ①hemodialysis（HD）, ②hemodiafiltration（HD+HDF）, ③ hemodialysis combined by continuous renal replacement therapy（HD+CRRT）.Serum AOPP、interleukin-6(IL-6)、monocyte chemotactic protein-1(MCP-1)、high sensitivity c-reactive protein (hs-CRP) , IMT and mass of carotid artery plaque were detected before and after one year treatment. Results The levels of serum AOPP、IL-6、MCP-1、hs-CRP in MHD patients were siginificantly higher than those in healthy controls (p<0.001). The levels of serum AOPP decreased after the treatment of HDF and CRRT (p<0.001) . After 12 –month treating , the level of serum AOPP increased of HD( P<0.01), meanwhile IMT and the mass of carotid artery plaques in patients with HDF and HD+CRRT were lower than that inpatients with HD. Serum level of AOPP was strongly associated with IMT and mass of carotid artery plaque (r=0.79, r=0.67) . Conclusions AOPP may be one of the risk factor for atherosclerosis. HDF and CRRT can clear AOPP effectively, and can improve the survival rate of MHD patients. |
| Key words: Blood purification Atherosclerosis Advanced oxidation protein products Oxidative stress |
