阿法骨化醇冲击治疗对维持性血液透析患者钙磷代谢、微炎症及氧化应激状态的影响  

Effects of alfacalcidol on calcic phosphor metabolization,microinflammation and oxidative stress in patients with maintenance hemodialysis

作　　者：王芳 谢敏妍 张东升 刘海俊 付喜花 WANG Fangaa;SIE Min-yana;ZHANG Dong-shenga;LIU Hai-junb;FU Xi-huac(Department of Nephrology;Department of Rheumatism,c.Department of Infectious Disease,Central Hospital of Panyu District in Guangzhou,Guangzhou 511400,China)

机构地区：[1]广州市番禺区中心医院肾内科,广州511400 [2]广州市番禺区中心医院风湿科,广州511400 [3]广州市番禺区中心医院感染科,广州511400

出　　处：《实用药物与临床》2018年第7期765-768,共4页Practical Pharmacy and Clinical Remedies

摘　　要：目的观察阿法骨化醇冲击治疗对维持性血液透析患者钙磷代谢、微炎症及氧化应激状态的影响。方法 80例维持性血透患者随机分为冲击组及对照组,每组40例,冲击组采用阿法骨化醇冲击治疗,每次4μg顿服,2次/周;对照组口服阿法骨化醇,每次0.5μg,1次/d。在治疗前及治疗后12周检测血磷、血钙、甲状旁腺激素(iPTH)、血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、髓过氧化氢酶(MPO)、谷胱甘肽过氧化物酶(GSH-PX)的水平。结果治疗前两组各项指标比较差异无统计学意义(P>0.05)。治疗12周后,两组患者血钙水平上升(P<0.05),冲击组血钙上升更显著(P<0.05),血磷水平无变化;冲击组iPTH明显下降(P<0.05),对照组iPTH无变化;两组患者CRP、IL-6、TNF-α、MDA、MPO均明显下降(P<0.05),冲击组下降较对照组更明显(P<0.05);两组患者GSH-PX明显上升(P<0.05),且冲击组改善更显著(P<0.05)。结论维持性血液透析患者存在微炎症及氧化应激状态,阿法骨化醇冲击治疗可以改善患者血钙及iPTH水平,同时对患者的微炎症及氧化应激状态具有明显的改善作用。Objective To observe the effects of alfacalcidol on calcic phosphor metabolization,microinflammation and oxidative stress in patients with maintenance hemodialysis. Methods Totally 80 patients with maintenancehemodialysis were divided randomly to treatment group and control group,40 cases in each group. Treatment group was given alfacalcidol therapy（4 μg,twice a week）,and control group received alfacalcidol therapy（0. 5 μg qd）. The serum phosphorus,serum calcium,parathyroid hormone（iPTH） levels,C-reactive protein（CRP）,interleukin 6（IL-6）,tumor necrosis factor-α（TNF-α）,malonaldehyde（M DA）,myeloperoxidase（M PO） and glutathione peroxidase（GSH-PX） were measured before and 12 weeks after treatment. Results Before treatment,there was no significant difference in the metrical indexes between the two groups（P〉 0. 05）. Atfet treatment for 12 weeks,the calcium levels of the two groups increased（P〈 0. 05）,and the increase of blood calcium in treatment group was more significant（P 〈0. 05）,but the level of serum phosphate had no obvious change in the two groups; the iPTH levels were significantly decreased in treatment group（P 〈0. 05）,but that in control group had no significant change; the levels of CRP,IL-6,TNF-α,M DA and M PO were significantly decreased in the two groups（P 〈0. 05）,especially in treatment group（P 〈0. 05）; the GSH-PX level was significantly increased in the two groups,and more evidently in treatment group（P〈 0. 05）. Conclusion The patients with maintenance hemodialysis exist microinflammation and oxidative stress. Alfacalcidol can effectively improve the levels of serum calcium level and iPTH,and alleviate microinflammation and oxidative stress state.

关 键 词：阿法骨化醇 维持性血液透析 钙磷代谢 微炎症状态 氧化应激 

分 类 号：R692.5[医药卫生—泌尿科学]