维生素E联合血液灌流在维持性血液透析患者中的临床应用价值  

Clinical application of vitamin E combined with hemoperfusion in maintenance hemodialysis patients

作　　者：段海玲[1] 崔向芹[1] 王宗宝[2] 刘观斌[3] 耿明亮[1] 

机构地区：[1]滨州市中心医院肾内科,山东滨州251700 [2]滨州市中心医院神经外科,山东滨州251700 [3]滨州市中心医院检验科,山东滨州251700

出　　处：《临床荟萃》2015年第11期1288-1291,共4页Clinical Focus

摘　　要：目的探讨维生素E联合血液灌流对维持性血液透析（MHD）患者氧化应激、微炎症和钙磷代谢紊乱状态的影响。方法本院2014年1~6月接受维持性透析治疗的患者60例,按照随机数字法分为两组,各30例。对照组采用血液透析治疗,试验组在此基础上采用维生素E联合血液灌流进行治疗。观察两组治疗前、治疗6个月时白细胞介素6（IL-6）、白细胞介素8（IL-8）、C-反应蛋白（CRP）、肿瘤坏死因子α（TNF-α）、丙二醛（MDA）、超氧化物歧化酶（SOD）、终末氧化蛋白产物（AOPP）、谷胱甘肽过氧化物酶（GSH-PX）以及血钙、血磷、1,25-（OH）2D3水平。结果治疗前两组相关指标比较差异均无统计学意义（P〉0.05）,治疗后6个月试验组血清IL-6、IL-8、CRP、TNF-α、MDA、AOPP和血磷水平低于治疗前,差异均有统计学意义（P〈0.01）,SOD、GSH-PX、血钙和1,25（OH）2D3高于治疗前,差异均有统计学意义（P〈0.01）,治疗后两组上述指标差异均有统计学意义（P〈0.05）。两组治疗期间均未发生过敏反应,出血,感染等严重的不良反应。结论维生素E联合血液灌流可以有效地改善维持性血液透析患者的微炎症状态和氧化应激状态,维持其钙磷代谢平衡,值得临床推广应用。Objective To explore the impact of vitamin E combined with hemoperfusion on oxidative stress,micro-inflammation and calcium-phosphate metabolism disorder in maintenance hemodialysis patients.Methods Sixty maintenance hemodialysis patients in our hospital from January 2014 to June 2014 were randomly divided into two groups.The control group was treated with hemodialysis.The observation group was treated by vitamin E plushemoperfusion in addition to hemodialysis.The changes of serum IL-6,IL-8,CRP,TNF-α,MDA,SOD,AOPP,GSH-PX,calcium,phosphorus and 1,25-（OH）2D3in two groups observed before treatment and 6 months after treatment.Results Before treatment,there were no difference in all indexes between two groups.IL-6,IL-8,CRP,TNF-α,MDA,AOPP and blood phosphorus of observation group in the 6th month were all higher than those before treatment and control group（P〈0.01）.SOD,GSH-PX,blood calcium and 1,25-（OH）2D3of observation group were both lower than those before treatment and contro1 group after 6months treatment（P〈0.01）.There were no severe adverse events in two groups.Conclusion Vitamin E combined with hemoperfusion could effectively improve the micro inflammation and oxidative stress,maintain the metabolism of calcium and phosphorus balance,which deserves clinical application.

关 键 词：肾透析 维生素E 灌流 炎症 氧化性应激 磷代谢障碍 钙代谢障碍 

分 类 号：R459.5[医药卫生—治疗学]