摘要
目的研究超纯水对维持性血液透析患者氧化应激和炎症水平的影响。方法对36例符合条件的患者采用重复测量自身对照的方法,测定在使用超纯水前、后6个月及12个月时血清晚期氧化蛋白产物(AOPP)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)、髓过氧化物酶(MPO)、白蛋白(Alb)、C-反应蛋白(CRP)、新喋呤、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)水平。结果改进水处理系统后,透析用水的细菌和内毒素含量明显下降(P<0.01)。随访一年中,各项检测指标在不同时间点的差异均有统计学意义(P<0.05);6个月时血清AOPP、MDA、GSH-Px、Alb、CRP、新喋呤、TNF-α水平较使用超纯水前明显改善(P<0.05),且MPO有非常显著的差异(P<0.01);12个月时IL-6(P<0.05)、MDA(P<0.01)水平进一步下降。相关分析显示血清MPO活性与AOPP及CRP水平在改用超纯水前后均呈正相关关系。结论改用超纯水后患者的氧化应激和炎症水平显著降低,且MPO也许可以同时提示氧化应激和炎症水平。
Objective To evaluate the effects of ultrapure water on the levels of oxidative stress and inflammation parameters in maintenance hemodialysis patients. Methods Thirty-six stable maintenance hemodialysis patients were involved in this study, who were flee of acute infection, vasculitis or disease activity and on hemodialysis therapy for at least 3 months before using ultrapure water. The parameters including serum advanced oxidation protein products （AOPP）, malondialdehyde （MDA）, glutathione peroxidase （GSH-Px）, myeloperoxidase （MPO）, albumin （Alb）, C-reactive protein （CRP）, neopterin, tumor necrosis factor （TNF）-α, and interleukin （IL）-6 were measured before and 6, 12 months after use of ultrapure water, respectively. Results After modification of the water management system, the microbial counts and endotoxin concentration decreased significantly （P〈0.01）. During the study period, the levels of the measured parameters gradually improved, showing significant difference between the time points of measurement （P〈0.05）. Use of ultrapure water for 6 months significantly improved serum AOPP, MDA, GSH-Px, MPO, Alb, CRP, neopterin, and TNF-α levels （P〈0.05）, and the level of IL-6 was further reduced after 12 months （P〈0.05）. Serum MPO activity was closely correlated with AOPP （r=0.335, P〈0.05） and CRP （r=0.369 or 0.347, P〈0.05） before or after use of ultrapure water. Conclusions Ultrapure water can improve the status of oxidative stress and inflammation in maintenance hemodialysis patients. Serum MPO activity may help estimate the levels of oxidative stress and inflammation .
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2007年第9期1435-1437,1450,共4页
Journal of Southern Medical University
关键词
超纯水
血液透析
氧化应激
炎症
ultrapure water
hemodialysis
oxidative stress
inflammation
