复方丹参片对维持性血液透析患者氧化应激和微炎症状态的干预作用

作者	单位
蒲超	遵义医学院附属医院肾内科贵州563003
杨亦彬	遵义医学院附属医院肾内科贵州563003
孙全林	遵义医学院附属医院肾内科贵州563003
曾远扬	遵义医学院附属医院肾内科贵州563003
祝荣文	遵义医学院附属医院肾内科贵州563003

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中文摘要:

目的研究复方丹参片对维持性血液透析(MHD)患者氧化应激和微炎症的影响。方法36例MHD0·5年以上的患者随机分为常规透析组和透析加丹参组,同时18名健康成人作为正常对照组。分别测定各组基础以及透析组1、2、3个月的血浆氧化应激指标(AOPP、MDA、SOD)和微炎症指标(CRP、IL-6、TNF-α)的水平。结果透析患者的CRP、IL-6、TNF-α、AOPP、MDA明显高于正常对照组(P<0·01)、SOD显著低于正常对照组(P<0·01)。常规透析组3个月时AOPP、MDA较服药前增加(P<0·05),SOD降低(P<0·05),CRP、IL-6、TNF-α增加但无显著性差异(P>0·05)。透析加丹参组在1、2、3个月时MDA、AOPP明显低于服药前以及同时点常规透析组(P<0·01),而SOD则显著增高(P<0·01),第3个月所测CRP低于服药前(P<0·05)以及同时点常规透析组(P<0·01),但IL-6、TNF-α降低不明显(P>0·05),透析加丹参组各时点的CRP、IL-6、TNF-α、AOPP、MDA仍高于正常对照组(P<0·01),SOD低于正常对照组(P<0·01)。结论血液透析可能加重MHD患者的氧化应激和微炎症,复方丹参片能有效地改善MHD患者的氧化应激和微炎症状态。

英文摘要:

ObjectiveTo investigate the effects of Salvia miltiorrhiza (SM) on oxidative stress and microinflammatory state in patients undergoing continuous hemodialysis (CHD). MethodsThirty-six patients who had received CHD for over half a year were assigned into the routine CHD group (18 cases) and the treated group treated with routine CHD plus SM (18 cases). Meanwhile, 18 healthy adults were taken as the normal control. Indexes related with oxidative stress malondialdehyde (MDA), advanced oxidative protein products (AOPP) and superoxide dismutase (SOD) and microinflammation C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α(TNF-α) were detected before and after 1, 2 and 3 months of treatment. ResultsThe levels of AOPP, MDA, CRP, IL-6 and TNF-α in patients were higher and SOD was lower than those in the normal control at all the time points (P<0.01). Compared with the baseline, the levels of AOPP and MDA in the routine CHD group significantly increased and SOD decreased after 3 months of treatment (P<0.05), but changes of CRP, IL-6 and TNF-α showed no significance though there were somewhat increment (P>0.05). The levels of AOPP and MDA were lower and SOD was higher after 1, 2 and 3 months of SM combined treatment, and CRP was lower after 3 months of treatment in the treated group than those of baselines and those at the corresponding time points in the routine CHD group (P<0.01), but IL-6 and TNF-α reduced insignificantly (P>0.05). ConclusionHemodialysis may aggravate the oxidative stress and microinflammation in patients, which could be obviously alleviated by SM.

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