中老年维持性血液透析患者氧化应激与左心室重塑的关系  

The Relationship Between Relevant Factors of Oxidative Stress State in MHD Patients and left Ventricular Remodeling

作　　者：金领微[1] 周志宏[1] 郑育[1] 李宝青[1] 徐晓杰[1] 杨琰[1] 陈琰[1] 徐玉兰[1] 

机构地区：[1]温州医学院附属第二医院血液净化中心,温州325088

出　　处：《中国中西医结合肾病杂志》2009年第10期882-885,共4页Chinese Journal of Integrated Traditional and Western Nephrology

基　　金：温州市科委基金资助项目(No.Y20080046)

摘　　要：目的:探讨维持性血液透析患者(MHD)血中脂质过氧化物丙二醛(MDA)、超氧化物岐化酶(SOD)、谷胱甘肽过氧化物酶(GPx)与其心脏结构和功能指标之间关系,MHD患者氧化应激相关因子与左心室重塑的关系。方法:随机选择老年MHD患者30例、中年MHD患者30例、健康人(对照组)28例,分别检测MDA、SOD、GPx水平,并应用超声心动图测定他们的左房内径(LAD)、左心室舒张末内径(LVDd)、左心室收缩末内径(LVDs)、室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室射血分数(LVEF)、计算左心室心肌重量指数(LVMI),胸部平片计算心胸比率。分析氧化应激与左心关系。结果:中、老年MHD组与正常对照组比较MDA水平显著高于对照组(P<0.05),老年组显著高于中年组;而中、老年MHD组与正常对照组比较GPx、SOD、Alb显著低于正常对照组(P<0.05),尤其老年组更低。MHD患者LAD、LVDd、LVDs、IVST、LVWPT值均明显高于对照组(P<0.05);LVEF较正常对照组明显降低(P<0.05);LVMI较正常对照组显著升高(P<0.01)。老年MHD组LAD、LVPWT、IVST、LVMI水平显著高于中年组(P<0.05),而LVEF显著低于中年组(P<0.05)。MDA分别与LAD、LVDs、LVDd、IVST、LVWPT、LVMI、C/T呈正相关(P<0.01),与LVEF呈负相关(P<0.01);SOD、GPx分别与LAD、LVDs、LVDd、IVST、LVWPT、LVMI、C/T呈负相关(P<0.05),与LVEF呈正相关(P<0.01)。结论:MHD患者存在氧化应激状态,与左心室重塑的发生和发展有关,老年MHD患者尤为显著。Objective：To discuss the relationship between the indexes of serum MDA, SOD, GPx, Alb and cardiac structure and function in MHD patients. Aslo we discussed the relationship between relevant factors of Oxidative stress state in MHD patients and left ventricular remodeling. Methods：30 senile MHD cases, 30 middle- aged MHD cases were randomly enrolled and 28 healthy adults were recruited as control group. Serum MDA, SOD, GPx, and Alb of them were determined. And we measured their LAD, LVDd, LVIN, IVST, LVPWT, LVFF and LVMI by echocardiogram, cardiac/chest ratio was figured out by X - ray chest film. Resuits：The indexe of MDA in MIlD cases were higher than those in control group. The differences of the indexes above among these three groups were significant（P〈0.05）. LAD, LVDd, LVDs, IVST and LVWPT in MIlD cases were notably higher than those in control group. The differences of LAD, LVDd, LVDs, IVST and LVWPT among these three groups were also significant （ P 〈 0.05）. Compared with those of control group, Alb and LVEF of MHD patients was manifestly lower（ P 〈 0.05 ）, and LVMI of MHD group strikingly higher（P〈0.01 ）. MDA was positively correlated with LAD, LVDs, LVDd, IVST, LVWPF and LVMI respectively （P〈0.05） ,and negatively correlated with LVEF（P〈O. 05）. LAD, LVPWT, IVST and LVMI in senile MHD group were significantly higher than those in middle aged MHD group, and LVEF in senile MHD group obviously lower（ P 〈 0.05 ）. Conclusion ： Ox- idative stress state exists in MHD sufferers;The Oxidative stress state is associated with the genesis and development of left ventricular remodeling, especially in eider MILD.

关 键 词：血液透析 氧化应激 左心室重塑 

分 类 号：R459.5[医药卫生—治疗学] R542.22[医药卫生—临床医学]