骨化三醇对维持性血液透析患者微炎症及氧化性应激状态的影响研究  

Calcitriol Improving Microinflammation and Oxidative Stress in Patients with Maintenance Hemodialysis

作　　者：刘春秋[1] 刘雷[1] 李良志[1] 何先红[1] 汤跃武[1] 史继红[1] 王军[1] 吴泽成[1] 

机构地区：[1]重庆三峡中心医院肾内科,重庆市404000

出　　处：《中国全科医学》2013年第5期516-519,共4页Chinese General Practice

摘　　要：目的观察骨化三醇对维持性血液透析(MHD)患者微炎症及氧化性应激状态的影响。方法选择我院行MHD的患者60例,按随机数字表法随机分为治疗组及对照组各30例,对照组给予常规药物治疗;治疗组在常规药物治疗的基础上加用骨化三醇胶丸,0.50μg/d口服治疗。均治疗12周,均不使用血管紧张素转换酶抑制剂、血管紧张素Ⅱ受体拮抗剂以及他汀类药物。另选择30例健康者作为正常组。观察治疗前后患者血清高敏C反应蛋白(hs-CRP)、白介素6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及血浆丙二醛(MDA)、谷胱苷肽过氧化物酶(GSH-PX)水平变化,并与正常组进行比较。结果治疗前,3组受检者的血清hs-CRP、IL-6、TNF-α水平及血浆MDA、GSH-PX水平比较,差异均有统计学意义(P<0.05),与正常组比较,治疗组和对照组患者的血清hs-CRP、IL-6、TNF-α及血浆MDA水平均升高,血浆GSH-PX水平均降低,差异有统计学意义(P<0.05)。骨化三醇治疗12周后,3组受检者的血清hs-CRP、IL-6、TNF-α水平及血浆MDA、GSH-PX水平比较差异仍均有统计学意义(P<0.05),与治疗前及对照组治疗后比较,治疗组患者的血清hs-CRP、IL-6、TNF-α及血浆MDA水平均降低,血浆GSH-PX水平升高,差异均有统计学意义(P<0.05);而对照组治疗12周后,血清hs-CRP、IL-6、TNF-α水平及血浆MDA、GSH-PX水平与治疗前比较差异均无统计学意义(P>0.05)。结论 MHD患者存在微炎症及氧化性应激状态,骨化三醇治疗可以显著改善MHD患者微炎症状态及氧化性应激水平。Objective To investigate the effect of Calcitriol on mieroinflammation and oxidative stress in maintenance hemodialysis （MHD） patients. Methods Sixty stable MHD patients were divided randomly into groups therapy and control, 30 in each. Control group were given conventional drug treatment; Therapy group were given, based on conventional, additional caleitriol soft capsules, orally, 0. 50μg/d. The course lasted 12 weeks, and the both groups didn＇t use angiotensin converting enzyme inhibitor （ACEI）, angiotensin II receptor antagonist or statins. Another 30 healthy subjects enrolled as normal group. Serum levels of high - sensitivity C - reactive protein （ hs - CRP） , interleukin 6 （ IL - 6）, TNF - α and plasma malonaldehyde （MDA） , glutathione peroxidase （GSH -PX） were observed. Results Before treatment, there was significant difference in hs - CRP, IL - 6, TNF - α, MDA, GSH - X between 3 groups （P 〈 0. 05）. As compared with normal group, the levels of hs - CRP, IL - 6, TNF -α , MDA increased, GSH - PX decreased, the difference was significant （P 〈 0. 05）. After 12 weeks of ealcitriol treatment, there was difference in hs - CRP, IL - 6, TNF - α, MDA, GSH - X between 3 groups （P 〈 0. 05 ）. As compared with pre -treatment and control group after treatment, hs - CRP, IL -6, TNF - α, MDA decreased, GSH -X increased in therapy group, the difference was significant （P 〈 0. 05）. There was not difference in hs - CRP, IL - 6, TNF - α, MDA, GSH -X between pre - and 12 - week treatments in control group （P 〉0. 05）. Conclusion Microinflammation and oxidative stress, existing in MHD patients, can be improved obviously by caleitriol.

关 键 词：维持性血液透析 微炎症状态 氧化性应激 骨化三醇 

分 类 号：R459.52[医药卫生—治疗学] R969.4[医药卫生—临床医学]