维持性血液透析患者透析充分性与氧化应激的关系  

Relationship between dialysis adequacy and oxidative stress in maintenance hemodialysis patients

作　　者：隋桂琴 姜玲[3] 仇方忻 姜国珍 张宁 刘雪梅[4] Sui Guiqin1,Jiang Ling2, Qiu Fangxin2, et al.(1 （1） Department of Outpatient, （2）Department of Nephrology, People＇s Hospital of Chengyang District,Qingdao 266109,China; 2 Blood Purification Center of Qingdao Municipal Hospital, Qingdao 266011, China)

机构地区：[1]青岛市城阳区人民医院门诊部,山东青岛266109 [2]青岛市城阳区人民医院肾内科,山东青岛266109 [3]青岛市市立医院血液净化中心,山东青岛266011 [4]青岛大学附属医院肾内科,山东青岛266003

出　　处：《国际泌尿系统杂志》2018年第5期819-822,共4页International Journal of Urology and Nephrology

摘　　要：目的 观察维持性血液透析（maintenance hemodialysis,MHD）患者透析充分性与氧化应激之间的关系,为临床实践提供理论依据.方法 选取2017年1月至2017年6月在本院血液净化中心行MHD患者76例,以尿素氮清除指数（Kt/V）评估患者透析充分性,将入选患者分为透析充分组与透析不充分组.采用硫代巴比妥酸法测定丙二醛水平,同时检测血红蛋白、部分生化指标、C反应蛋白、甲状旁腺激素等水平.结果 透析充分组丙二醛水平显著低于透析不充分组（P＜0.01）;透析充分组白蛋白、高密度脂蛋白显著优于透析不充分组（P＜0.05）;血肌酐、低密度脂蛋白、C反应蛋白显著高于透析不充分组（P＜0.05）;相关性分析：透析充分性与白蛋白（r =0.230,P＜0.05）、高密度脂蛋白（r=0.309,P＜0.01）呈正相关,与血肌酐（r=-0.281,P＜0.05）、低密度脂蛋白（r=-0.293,P＜0.01）、血磷（r=-0.282,P＜0.05）、C反应蛋白（r=-0.286,P＜0.05）、丙二醛（r=-0.692,P＜0.01）呈负相关.多元线性逐步回归分析显示,透析充分性是丙二醛的独立相关因素（P＜0.01）.结论 MHD患者透析充分性与氧化应激密切相关,提高MHD患者透析充分性可以改善其氧化应激状态. Objective To provide a theoretical basis for clinical practice observing the relationship between dialysis adequacy and oxidative stress in maintenance hemodialysis （MHD） patients.Methods Seventy-six MHD patients were recruited from the department of blood purification center of Chengyang people＇s hospital.Dialysis adequacy was assessed by urea clearance index （Kt/V）.The subjects were divided into dialysis adequacy group and inadequate dialysis group.The levels of malondialdehyde （MDA） were measured by thiobarbituric acid method.Hemoglobin,partial biochemical indexes,C-reactive protein and parathyroid hormone were assayed.Changes of these parameters in different groups and their relevance to dialysis adequacy were analyzed.Results MDA levels were significantly lower in dialysis adequacy group than that in inadequate dialysis group （P 〈0.01）.Albumin and high-density lipoprotein in dialysis adequacy group were significantly better than that in inadequate dialysis group （P 〈 0.05）,while serum creatinine,low density lipoprotein and C-reactive protein were significantly higher than that in inadequate dialysis group （P 〈 0.05）.Dialysis adequacy were positively correlated with albumin （r =0.230,P 〈 0.05）,high density lipoprotein （r =0.309,P 〈0.01） and was negatively correlated with serum creatinine （r =-0.281,P 〈 0.05）,low density lipoprotein （r =-0.293,P 〈 0.01）,serum phosphorus （r =-0.282,P 〈 0.05）,C-reactive protein（r=-0.286,P 〈0.05）,MDA （r =-0.692,P 〈0.01）.Multiple regression results showed that dialysis adequacy was associated with MDA levels independently （P 〈 0.01）.Conclusions Dialysis adequacy is closely related to oxidative stress in MHD patients.In order to improve the oxidative stress in MHD patients can be achieved by improving the dialysis adequacy.

关 键 词：肾透析 氧化性应激 

分 类 号：R692.5[医药卫生—泌尿科学]