静脉补铁对腹膜透析患者氧化应激状态的影响_医学论文.docVIP

静脉补铁对腹膜透析患者氧化应激状态的影响_医学论文 静脉补铁对腹膜透析患者氧化应激状态的影响_医学论文 作者：杜艺　李宓　罗杏英　刘德慧 【摘要】 　　目的： 探讨静脉铁剂对腹膜透析患者氧化应激状态的影响. 方法： 选择持续性不卧床腹膜透析（CAPD）患者31例，随机分为静脉组（Ⅰ组，11例），口服组（Ⅱ组，10例），和未补铁组（Ⅲ组,10例），观察用药前后血红蛋白浓度（Hb），红细胞压积(Hct)，血清铁(SI)，血清铁蛋白（SF），转铁蛋白饱和度（TSAT）等指标以及血清C反应蛋白(CRP)和丙二醛（MDA），谷胱苷肽过氧化物酶（GSH），晚期糖基化终产物(AGE)，晚期氧化蛋白产物(AOPP)等炎症和氧化应激指标. 结果： ① 治疗4 wk时，Ⅰ， Ⅱ两组患者Hb, Hct, SI, SF, TSAT均较治疗前上升，且高于Ⅲ组；SI, SF, TSAT值Ⅰ组高于Ⅱ组,差异有统计学意义(0.05). ② 治疗8 wk时，3组患者Hb, Hct, SI, SF, TSAT均较治疗前上升，Ⅰ组不仅高于同组治疗4 wk时且高于Ⅱ， Ⅲ两组；Ⅱ组高于Ⅲ组，差异有统计学意义(0.05). ③ Ⅰ组患者使用静脉铁剂后1 h, MDA，AOPP水平升高，GSH水平下降；AGEs，CRP水平升高,在4 wk时较治疗前及1 h差异有统计学意义且较Ⅱ， Ⅲ组水平上升；Ⅱ组CRP水平高于Ⅲ组，差异有统计学意义. ④ 4 wk时Ⅱ组AOPP水平升高，与治疗前相比差异有统计学意义且高于Ⅰ， Ⅲ两组. 结论： ① 静脉补铁可有效改善CAPD患者贫血及缺铁状态. ② CAPD患者接受静脉铁剂治疗时，可能会诱导炎症及氧化应激反应的加剧. ③ 口服补铁4 wk后可引起CAPD患者AOPP水平的升高. 【关键词】 腹膜透析；贫血；氧化性应激；注射，静脉内；铁 　　【Abstract】 AIM: To investigate the influence of intravenous iron therapy on oxidative stress in peritoneal dialysis patients. METHODS: Thirtyp(group Ⅰ, n=11),oral iron group(group Ⅱ, n=10), and noniron group(groupⅢ, n=10). The indices of hemoglobin(Hb), hematocrit(Hct) , serum iron(SI), serum ferrintin(SF), transferrin saturation(TSAT), Creactive protein（CRP）,advanced oxidation protein products (AOPP) ,malondialdehyde（MDA）,advanced glycation end products (AGEs), and glutathione peroxidase (GSHent, the Hb, Hct, SI, SF and TSAT levels increased significantly in group Ⅰ and group Ⅱ, which were also significantly higher than those in groupⅢ. The SI, SF and TSAT levels in group Ⅰ were significantly higher than those in groupⅡ (0.05). ② Eight weeks after treatment, the Hb, Hct, SI, SF, TSAT levels elevated significantly in all patients. The levels of these indices were significantly higher in groupⅠthan in groupⅡand groupⅢ, and higher in groupⅡ than in groupⅢ (0.05). ③ After the infusion of iron, the levels of MDA and AOPP increased significantly and reached the peak level at 1 h while the level of GSHPx decreased significantly the levels of AGEs and CRP increased in groupⅠ, and were higher at 4 weeks