贵州医科大学学报

2017, v.42;No.201(06) 703-707

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α-硫辛酸对ESRD血液透析患者微炎性因子、部分营养学指标以及血清Hcy、PTH、β2-MG的影响
Effects of Alpha-lipoic Acid on Serum Inflammatory Factors,Nutritional Parameters,Serum Hcy,PTH and β2-MG in ESRD Patients Received Hemodialysis

王雪;
WANG Xue;The Outpatient Quiet Sections,First Affiliated Hospital of Harbin Medical University;

摘要(Abstract):

目的:研究α-硫辛酸对终末期肾病(ESRD)血液透析(HD)患者血清微炎性因子、部分营养学指标以及血清同型半胱氨酸(Hcy)、甲状旁腺激素(PTH)、血清β2-微球蛋白(β2-MG)的影响。方法:进行HD的68例ESRD患者,随机分为对照组和观察组;对照组患者入院后给予ESRD肾内科常规治疗以及血液透析,观察组患者在对照组的基础上外加领给予α-硫酸锌600 mg/d,每日分3次服,疗程8周;比较两组患者治疗前后血清微炎性因子超敏C-反应蛋白(hs-CRP)、白细胞介素-6(IL-6)、白细胞介素-8(IL-8)和肿瘤坏死因子-α(TNF-α),营养指标血红蛋白(Hb)、白蛋白(Alb)、血清总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)及低密度脂蛋白胆固醇(LDL-C)以及血清Hcy、PTH、β2-MG的变化。结果:与治疗前比较,治疗后两组患者血清hs-CRP、IL-6、IL-8、TNF-α、Hcy、PTH和β2-MG水平明显降低,且观察组下降更明显,差异有统计学意义(P<0.05);与治疗前比较,治疗后观察组患者血清Hb和Alb水平明显增高,且高于对照组,差异有统计学意义(P<0.05)。结论:α-硫辛酸用于治疗的ESRD患者,可降低肾脏的炎症反应,改善患者的营养状况,增加Hcy、PTH和β2-MG的清除。
Objective: To study the effects of alpha-lipoic acid on serum inflammatory factors,nutritional parameters,serum Hcy,PTH and β2-MG in ESRD patients received hemodialysis. Methods:A total of 68 patients with end-stage renal disease( ESRD) undergoing hemodialysis in our hospital from September 2013 to September 2015 were recruited in our study and randomly divided into control group( n = 34) and observation group( n = 34). The control group received routine ESRD treatment and hemodialysis,while patients in the observation group or in the control group also received zinc sulfate treatment of 600mg/d on the basis of the control group for 8 weeks. The serum levels of inflammatory factors( hs-CRP,IL-6,IL-8,TNF-α),nutritional parameters( Hb、Alb、TC、TG、HDL-C and LDL-C),as well as serum Hcy,PTH,β2-MG in the two groups before and after treatment were collected and compared. Results: After treatment,the serum levels of hs-CRP,IL-6,IL-8 and TNF-α in the two groups were significantly lower than those before treatment,and the patients in the observation group decreased more significantly,so the difference was statistically significant( P < 0. 05). Aftertreatment,the levels of serum Hb and Alb were significantly increased before treatment( P < 0. 05),and significantly higher than the levels of serum Hb and Alb( P < 0. 05) in control group patients,and the levels of serum TC,TG,HDL-C and LDL-C did not change significantly( P > 0. 05); After treatment,the serum levels of Hcy,PTH and beta 2-MG in the two groups were significantly lower than those before treatment,and the observation group decreased more significantly. The difference was statistically significant( P < 0. 05). Conclusion: Alpha-lipoic acid as the treatment of ESRD patients received hemodialysis can effectively reduce the inflammation of kidney,improve the nutritional status of patients,increase the clearance of virulence factors of Hcy,PTH and β2-MG,which has good clinical value and worthy of promotion.

关键词(KeyWords): 终末期肾病;血液透析;α-硫辛酸;血清;白细胞介素;C-反应蛋白
end-stage renal disease;hemodialysis;alpha-lipoic acid;serum;interleukin;C reactive protein

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金(81202189)

作者(Author): 王雪;
WANG Xue;The Outpatient Quiet Sections,First Affiliated Hospital of Harbin Medical University;

Email:

DOI: 10.19367/j.cnki.1000-2707.2017.06.018

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