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目的探讨慢性肾功能衰竭(chronic renal failure,CRF)维持性血透患者应用人类重组促红细胞生成素(recombinant human erythropoietin,r-HuEPO)对体内炎症反应及氧化应激状态的影响。方法选择35例慢性肾衰维持性血透患者(肾衰组),35例健康成人作对照(对照组)。肾衰组应用r-HuEPO治疗3个月及6个月后,检测患者血红蛋白(Hb)、红细胞压积(Hct)、血浆超敏C反应蛋白(hs-CRP)及晚期氧化蛋白产物(AOPP)、丙二醛(MDA),红细胞膜Na+-K+-ATP酶活性的变化。结果治疗前肾衰组患者血浆中hs-CRP、MDA、AOPP含量明显高于对照组患者,而红细胞膜Na+-K+-ATP酶活性明显低于对照组(P<0.01),且呈显著负相关(r=-0.57、r=-0.67、r=-0.78,P<0.05)。r-HEPO治疗3个月后,血Hb、Hct明显上升,而hs-CRP、MDA、AOPP含量和Na+-K+-ATP酶活性变化不显著,在治疗6个月后,Na+-K+-ATP活性显著升高(P<0.05),hs-CRP、MDA、AOPP含量则显著下降(P<0.05)。结论r-HuEPO长程治疗在改善慢性肾衰维持性血透患者贫血状态的同时,可有效缓解患者体内炎症及氧化应激状态。
Objective To investigate the effect of human recombinant human erythropoietin (r-HuEPO) on inflammatory reaction and oxidative stress status in patients with chronic hemorrhagic failure (CRF) maintenance hemodialysis. Methods 35 patients with chronic renal failure hemodialysis patients (renal failure group), 35 healthy adults as control (control group). Renal failure patients were treated with r-HuEPO for 3 months and 6 months, then the levels of hemoglobin (Hb), hematocrit (Hct), plasma hs-CRP and AOPP were measured. , Malondialdehyde (MDA) and erythrocyte membrane Na + -K + -ATPase activity. Results The plasma levels of hs-CRP, MDA and AOPP in patients with renal failure before treatment were significantly higher than those in the control group, while the activity of Na + -K + -ATPase in erythrocyte membrane was significantly lower than that in the control group (P <0.01) (r = -0.57, r = -0.67, r = -0.78, P <0.05). After 3 months of r-HEPO treatment, blood Hb and Hct increased significantly, while the content of hs-CRP, MDA, AOPP and Na + -K + -ATPase activity did not change significantly. After 6 months, the activity of Na + -K + -ATP (P <0.05), while the levels of hs-CRP, MDA and AOPP decreased significantly (P <0.05). Conclusion Long-term treatment with r-HuEPO can effectively alleviate the inflammation and oxidative stress in patients with chronic renal failure with hemodialysis.