α-硫辛酸对终末期肾病血液透析患者炎性因子和营养指标的影响研究  

Effects of alpha-lipoic acid on serum inflammatory factors and nutritional parameters in ESRD patients receiving hemodialysis

作　　者：刘飞[1] 

机构地区：[1]兰州军区兰州总医院肾脏病内科,兰州730050

出　　处：《临床肾脏病杂志》2017年第12期740-743,共4页Journal Of Clinical Nephrology

摘　　要：目的研究α-硫辛酸对终末期肾病(end stage renal disease,ESRD)血液透析患者血清炎性因子、营养指标的影响,为临床改善ESRD血液透析患者肾功能提供理论基础。方法本次临床试验研究纳入2013年9月至2015年9月于兰州军区兰州总医院进行血液透析的ESRD患者共68例,按其入院顺序随机分为对照组(n=34)和观察组(n=34)。对照组患者入院后给予ESRD肾内科常规治疗及血液透析,观察组患者在对照组的基础上再加α-硫辛酸进行治疗。比较治疗前后2组患者血清炎性因子:超敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)、白细胞介素8(interleukin-8,IL-8)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α);营养指标:血红蛋白(hemoglobin,Hb)、白蛋白(albumin,Alb)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白胆固醇(high density lipoprotein cholesterol,HDL-C)以及血清同型半胱氨酸(homocysteine,Hcy)、甲状旁腺素(parathyroid hormone,PTH)、β2-微球蛋白(β2-microglobulin,β2-MG)的变化。结果治疗后,2组患者的血清hs-CRP、IL-6、IL-8和TNF-α水平较治疗前显著降低,且观察组患者上述指标下降更明显,差异有统计学意义(P<0.05)。治疗后观察组患者血清Hb和Alb水平较治疗前显著上升(P<0.05),且显著高于对照组患者血清Hb和Alb水平(P<0.05),而血清TC、TG、HDLC及LDL-C水平无明显变化(P>0.05);对照组患者治疗前后各项指标均无明显变化(P>0.05),治疗后两组间血清TC、TG、HDL-C及LDL-C水平差异无统计学意义(P>0.05)。治疗后2组患者的血清Hcy、PTH和β2-MG水平较治疗前均显著降低,且观察组上述指标下降更明显,差异有统计学意义(P<0.05)。结论α-硫辛酸用于治疗ESRD血液透析患者,可改善肾脏的炎症反应,提高患者的营养状况,增加Hcy、PTH和β2-MG清除,具有较�Objective To study the effects of alpha-lipoic acid on serum inflammatory factors,and nutritional parameters in end-stage renal disease（ESRD）patients receiving hemodialysis.Methods A total of 68 patients with ESRD undergoing hemodialysis in our hospital from September 2013 to September 2015 were recruited in our study and randomly divided into control group（n=34）and observation group（n=34）.The control group received routine ESRD treatment and hemodialysis,while the observation group received alpha-lipoic acid treatment additionally on the basis of routine treatment.The serum levels of inflammatory factors（hs-CRP,IL-6,IL-8,TNF-α）,nutritional parameters（Hb,Alb,TC,TG,HDL-C and LDL-C）,as well as serum Hcy,PTH,β2-MG in the two groups before and after treatment were collected and compared.Results After treatment,the serum levels of hs-CRP,IL-6,IL-8 and TNF-αin the two groups were significantly lower than those before treatment,and those were decreased more significantly in the observation（P〈0.05）.After treatment,serum Hb and Alb levels were significantly increased as compared with those before treatment（P〈0.05）,and those were significantly higher in the observation group than those in the control group（P〈0.05）.The serum TC,TG,HDL-C and LDL-C levels had no significant change（P〈0.05）.There were no significant differences in the above indexes of the control group before and after treatment（P〈0.05）.There was no statistically significant difference in serum TC,TG,HDL-C and LDL-C levels between the two groups after treatment（P〈0.05）.After treatment,the serum levels of Hcy,PTH and beta 2-MG in the two groups were significantly lower than those before treatment,more significantly in the observation group than in the control group（P〈0.05）.Conclusions Alphalipoic acid used in ESRD patients receiving hemodialysis can effectively reduce the inflammation of kidney,improve the nutritional status of patients,and increase the clearance of Hcy,PTH andβ2-MG,which has good

关 键 词：终末期肾病 血液透析 Α-硫辛酸 炎性因子 营养状况 

分 类 号：R692.5[医药卫生—泌尿科学]