低分子肝素对老年胃癌根治术患者的氧化应激反应及肾功能的影响  

Effect of low molecular weight heparin on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms

作　　者：唐人[1] 熊剑勇[1] 刘丹[2] 李其云[1] 易波[1] 

机构地区：[1]江西省肿瘤医院腹外二科,江西南昌330029 [2]南昌大学药学院,江西南昌330031

出　　处：《中国生化药物杂志》2014年第3期74-77,共4页Chinese Journal of Biochemical Pharmaceutics

基　　金：国家自然科学基金项目(81160309);江西省科技厅科技支撑项目-社会发展支撑计划项目(2010BSA13900);江西省自然科学基金项目(2012NSA12700)

摘　　要：目的：探讨低分子肝素对老年胃癌根治术患者的氧化应激及肾功能的影响。方法90例拟行胃癌根治术的老年胃癌患者，随机分为低分子肝素组（Ⅰ组，n＝45）和对照组（Ⅱ组，n＝45），Ⅰ组患者于麻醉诱导前至术后5 d给予皮下注射低分子肝素钙（100u/kg，1次/d），Ⅱ组给予等剂量生理盐水处理；分别在麻醉诱导前（T0）、术毕（T1）、术后第1 d（T2）、术后第3 d（T3）及术后第5 d （T4）抽取静脉血测定血浆丙二醛（Malondialdehyde，MDA）、红细胞醛糖还原酶（Aldose Reductase，AR）、超氧化物歧化酶（Superoxide dismutase，SOD）及过氧化氢酶（Catalase，CAT）活性水平，血肌酐（Creatinine，Cr）及血尿素氮（Blood urea nitrogen，BUN）；同时在相同时间点留取尿标本测定微量白蛋白（Albumin，Alb）及N-乙酰-β-D-氨基葡萄糖苷酶（N-acetyl-beta-D-amino glycosidase enzymes，NAG）含量。结果2组患者的MDA、AR、SOD及CAT在不同时间点组内比较具有统计学差异（P＜0.05），2组MDA和AR从T0到T4先升高后降低，都在T2达到峰值，2组SOD及CAT从T0到T4先降低后升高，都在T2达到波谷；2组患者的MDA、AR、SOD及CAT在T1～T3比较差异具有统计学意义（P＜0.05），Ⅰ组的MDA和AR在T1、T2、T3显著低于Ⅱ组（P＜0.05），SOD和CAT在T1、T2、T3显著高于Ⅱ组（P＜0.05）；2组患者的血浆Cr和 BUN 在不同时间点组内及组间比较无统计学差异，2组的尿Alb/Cr分别在T1、T2显著高于T0（P＜0.05），Ⅰ组的尿Alb/Cr在T1显著低于Ⅱ组（P＜0.05）；2组的尿NAG/Cr在T1、T2、T3显著高于T0（P＜0.05），但Ⅱ组在T4仍然高于T0（P＜0.05），T1～T4时Ⅰ组的尿NAG/Cr显著低于Ⅱ组（P＜0.05）；2组患者的MDA和AR在T1、T2与Alb/Cr和NAG/Cr分别呈正相关（P＜0.05），SOD和CAT在T1、T2与尿Alb/Cr和NAG/Cr分别呈负相关（P＜0.05）。结果老年患者胃癌根治术的氧化应激反应与围Objective To investigate effect of low molecular weight heparin (LMWH)on oxidative stress and renal function in elderly patients undergoing gastrectomy of stomach neoplasms. Methods 90 elderly patients undergoing radical surgery were randomly divided into LMWH group (Ⅰ group,n=45)and control group (Ⅱ group,n=45). Patients inⅠ group received a subcutaneous injection of LMWH(100 u/kg,1/d)from the time before anesthesia induction to postoperative 5 days,and patients in Ⅱ group were given equal volume of saline. Venous blood samples were collected to determine level of malondialdehyde(MDA),aldose reductase(AR)activity level,superoxide dismutase(SOD)activity level,catalase (CAT)activity level,creatinine(Cr)and blood urea nitrogen(BUN)before anesthesia induction(T0 ),at the end of the surgery(T1 ),on postoperative 1 day(T2),3 days(T3)and 5 days(T4)respectively;urine specimen were also collected to measured albumin(Alb)and N-acetyl-beta-D-amino glycosidase enzymes(NAG)at the same time points. Results There were obvious statistical differences in MDA,AR,SOD and CAT at different time points by intra-group comparison (P<0.05 ). MDA and AR rose first and then fell in two groups,and both reached the peak at T2 ,whereas SOD and CAT had the opposite trends. There were obvious statistical differences in MDA,AR,SOD and CAT at T1 ~T3 (P<0.05 ). MDA and AR inⅠgroup at T1 ,T2 and T3 was lower than those in groupⅡ(P<0.05 ),whereas SOD and CAT inⅠgroup at T1 ,T2 and T3 were significantly higher than those&nbsp;in group Ⅱ(P<0.05). Cr and BUN of both groups were found no significant statistical difference within the group and between groups(P>0.05).Alb/Cr of both groups at T1 and T2 were significantly higher than those at T0 (P<0.05 ),while Alb/Cr in Ⅰ group at T1 was obviously lower than Ⅱgroup(P<0.05 ).NAG/Cr in both groups at T1 ,T2 and T3 were significantly higher than those at T0 (P<0.05 ),while NAG/Cr inⅡ group at T4 was still higher than that at T0 (P<0.05 ),and NAG/Cr inⅠgroup at T1 ~T4 was obviously low

关 键 词：低分子肝素 胃癌根治术 氧化应激 肾功能 

分 类 号：R735[医药卫生—肿瘤]