终末期肾病患者脂质过氧化水平的变化  

Lipid peroxidation in patients with end stage renal disease

作　　者：梁敏[1] 侯凡凡[1] 刘志强[1] 王力[1] 田建伟[1] 

机构地区：[1]第一军医大学南方医院肾内科中国人民解放军肾脏病研究所,广州510515

出　　处：《肾脏病与透析肾移植杂志》2003年第4期324-326,共3页Chinese Journal of Nephrology,Dialysis & Transplantation

基　　金：国家自然科学基金项目 (NO :30 10 0 0 82 ) ;广东省自然科学基金项目 (NO :0 0 10 87) ;全军医药卫生科研基金项目 (NO :0 12 0 79)

摘　　要：目的 :研究慢性终末期肾病 (ESRD)脂质过氧化状况及肾替代治疗对其的影响。　 方法 :观察对象分为正常对照组、慢性肾功能不全非透析 (CRF)组、持续性不卧床腹膜透析 (CAPD)组和血液透析 (HD)组 ;测定各组以及HD前后血浆丙二醛 (MDA)、脂氢过氧化物 (LOOH)含量和血浆抗氧化型LDL抗体 (anti oxLDLAb)水平。　 结果 :ESRD患者血浆MDA、LOOH和anti oxLDLAb水平均比正常对照组明显升高 (P均 <0 0 5 ) ;CRF组血浆MDA、LOOH和anti oxLDLAb水平与SCr浓度呈正相关 (P均 <0 0 1) ,与Ccr呈负相关 (P均 <0 0 1) ;CAPD组血浆MDA含量比CRF组显著升高 (P <0 0 5 ) ;HD组血浆MDA、LOOH和anti oxLDLAb水平均比CRF组明显增高 ,MDA和LOOH浓度比CAPD组明显升高 (P均 <0 0 5 ) ;单次HD前后上述指标无明显变化 (P均 >0 0 5 )。　 结论 :ESRD患者脂质过氧化反应增强 ,并随肾功能恶化而加重 ,HD可能进一步加剧这种病理生理改变。Objective:To evaluate the changes of blood lipid peroxidation in patients with chronic renal failure (CRF),and effects of dialysis on the blood lipid peroxidation. Methodology:One hundred and thirty four patients with end stage renal failure (ESRF) were involved in the study. They were 52 pre-dialysis chronic renal failure (CRF) patients, 14 continuous ambulatory peritoneal dialysis (CAPD) and 68 stable hemodialysis (HD) patients. Twenty age and sex matched healthy adults were regarded as normal controls. Plasma levels of malondialdehyde (MDA), lipid hydroperoxides (LOOH), and anti-oxLDL antibody were monitored in the four groups, and their levels were compared between pre- and post-dialysis section in 20 HD patients. Results:The plasma levels of MDA, LOOH and anti-oxLDL antibody in ESRF patients were higher than those of normal controls (P<0.05). The levels of MDA, LOOH and anti-oxLDL correlated inversely with clearance of creatinine (r=-0.473, -0.422, -0.395, respectively, P<0.01) in CRF patients. The plasma levels of MDA in CAPD, and levels of MDA, LOOH and anti-oxLDL in HD were increased significantly (P<0.05) as compared with CRF patients. The plasma concentration of MDA and LOOH in HD patients was higher than those of CAPD cases (P<0.05). There was no difference in the concentration of lipid peroxidation between pre- and post-hemodialysis section. Conclusion:Lipid peroxidation is increased in patients with end stage renal failure, which might be aggravated by hemodialysis.

关 键 词：终末期肾病 脂质过氧化 肾替代治疗 慢性肾功能不全 持续性不卧床腹膜透析 血液透析 

分 类 号：R692.5[医药卫生—泌尿科学]