辛伐他汀对维持性血液透析患者氧化应激及微炎症状态的影响

目的：探讨辛伐他汀对维持性血液透析（MHD）患者氧化应激及微炎症状态的影响。方法选择80例尿毒症血透患者分为两组,单纯血透组和辛伐他汀治疗组患者各40例,观察治疗前后血清中丙二醛（MDA）,超氧化物歧化酶（SOD）和血清总抗氧化物能力（T-AOC）等氧化指标以及血清C-反应蛋白、白细胞介素-6（IL-6）、肿瘤坏死因子-α（TNF-α）等炎症指标的变化。结果研究组给予辛伐他汀治疗后,患者MDA、CRP、IL-6和TNF-α较治疗前和对照组明显降低（P〈0.05）,SOD活性、T-AOC活性较治疗前升高（P〈0.05）,而对照组治疗前后各项指标差异无统计学意义（P〉0.05）。结论辛伐他汀能在一定程度上改善MHD患者的氧化应激和微炎症状态,且不良反应少,具有广泛的临床应用潜能。     

抗坏血酸对维持性血液透析氧化应激及微炎症状态的影响

目的探讨大剂量抗坏血酸对维持性血液透析患者氧化应激及微炎症的影响。方法该院血液净化中心MHD患者60例,分为抗坏血酸治疗组30例和非治疗组30例,治疗组每次透析开始给予抗坏血酸持续静脉滴注至透析结束,治疗3月。非治疗组30例未给予抗坏血酸静脉滴注。20例对照组为健康体检者。测定MHD患者透析前后及治疗前后血浆丙二醛含量（MDA）、超氧化物歧化酶活力（SOD）、血浆抗坏血酸含量、超敏C反应蛋白（Hs—CRP）。结果MHD组血浆MDA含量、血清HsCRP明显高于对照组（P〈0．01）,SOD、抗坏血酸含量明显低于对照组（P〈0．01）。MHD组治疗组治疗后血浆MDA含量、血清HsCRP低于治疗前（P〈0．05）,而血清SOD、抗坏血酸含量高于治疗前（P〈0．05,P〈0．01）。3月后治疗组与未治疗组相比,血浆MDA含量、血清HsCRP降低（P〈0．05,P〈0．01）,但仍高于对照组。而SOD、抗坏血酸含量升高（P〈0．01）。结论MHD患者体内存在OS、微炎症状态,抗氧化剂抗坏血酸能有效改善MHD患者OS及微炎症状态。     

高通量血液透析对糖尿病肾病患者氧化应激及微炎症状态的影响

目的 探讨高通量血液透析(HFHD)对糖尿病肾病患者氧化应激及微炎症状态的影响.方法 选取会昌县人民医院2018年1月—2020年1月收治的糖尿病肾病患者72例,以治疗方式不同分为参照组与研究组,各36例.参照组予以低通量血液透析,研究组予以HFHD.2组均接受6个月的血液透析.比较2组治疗前后氧化应激因子〔超氧化物歧...     

缬沙坦对维持性血液透析患者微炎症状态的影响

目的观察缬沙坦治疗对尿毒症维持性血液透析患者微炎症状态的影响,探讨血管紧张素Ⅱ（AngⅡ）1型受体拮抗剂在治疗尿毒症患者微炎症状态中的作用。方法选择本院肾内科维持性血液透析患者54例,测定C反应蛋白（CRP）、白细胞介素-6（IL-6）、肿瘤坏死因子-a（TNF-a）水平后,随机分为缬沙坦治疗组和非缬沙坦治疗组。用药后分别12周、24周检查CRP、IL-6、TNF-a。并设30例健康者作对照比较。结果①尿毒症维持性血液透析患者CRP、IL-6、TNF-a显著高于健康者（P〈0.05）;②治疗后12周、24周,缬沙坦治疗组CRP、IL-6、TNF-a的水平均有下降,其下降的水平与治疗前及非治疗组相比,差异具有显著性（P〈0.05）。结论应用缬沙坦治疗能改善尿毒症患者的微炎症状态,并且这种改变随治疗时间延长愈明显。     

大黄减轻维持性血液透析患者静脉铁剂诱导的氧化应激和微炎症反应

目的探讨大黄对维持性血液透析（MHD）患者静脉铁剂诱导的氧化应激和微炎症反应的影响。方法选取在该院血液净化中心行MHD治疗的患者80例,随机分为对照组（A组）和大黄治疗组（B组）。B组给予大黄泡水服用8周。分别于治疗前后检测丙二醛（MDA）、超氧化物歧化酶（SOD）、谷胱甘肽过氧化物酶（GSH-px）、C反应蛋白（CRP）、肿瘤坏死因子（TNF）-α、白介素（IL）-1β、IL-10等。结果治疗后,两组的SOD和GSH-px较治疗前下降,MDA、CRP、TNF-α、IL-1β均较治疗前升高（P〈0.05或0.01）;B组SOD和GSH-px均较A组升高（P〈0.05或0.01）,MDA、CRP、TNF-α、IL-1β均较A组降低（P〈0.05或0.01）,两组间IL-10差异无统计学意义。结论大黄可以减轻静脉铁剂诱导的氧化应激和微炎症反应。     

厄贝沙坦对维持性血液透析患者微炎症状态的影响

目的:探讨厄贝沙坦对维持性血液透析(MHD)患者微炎症状态的影响.方法:选择52例行MHD治疗的慢性肾衰患者,随机分为厄贝沙坦治疗组27例和非厄贝沙坦治疗组25例,并设28例健康对照组作为比较,检测治疗前及治疗6个月后血清C-反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α).结果:尿毒症MHD组CRP,IL-6,TNF-α显著高于健康对照组(P<0.01),治疗6个月后,厄贝沙坦治疗组CRP,IL-6,TNF.d的水平均有所下降,厄贝沙坦治疗组CRP,IL-6,TNF-α下降的水平与治疗前及非厄贝沙坦治疗组相比,差异具有显著性(P<0.05);非厄贝沙坦治疗组CRP,IL-6,TNF-α的水平较治疗前有所上升(P<0.05).结论:尿毒症患者体内存在微炎症状态,厄贝沙坦可改善MHD患者的微炎症状态.     

补锌治疗对维持性血液透析患者氧化应激状态的影响

目的 观察补锌治疗前、后血液透析患者血清锌水平及氧化应激指标的变化情况。方法 以2016年1月到2017年12月芜湖市第二人民医院维持性血液透析患者95例为研究对象,分析透析患者血清锌水平并与健康对照组进行比较。随后将透析患者按照随机数字表法分为A、B两组,A组先给予口服硫酸锌300 mg/d,B组给予淀粉胶囊,8周后两组均同时停服至第12周,13周开始后,A组给予淀粉胶囊,B组给予硫酸锌300 mg/d,口服至20周。分别在试验前及试验8、12、20周后测定血清锌浓度、丙二醛（MDA）含量及谷胱甘肽过氧化物酶（GSH-Px）和超氧化物歧化酶（SOD）活性。结果 与健康对照组相比,维持性血液透析患者MDA水平升高（P<0.05）,血清锌,GSH-Px和SOD活性降低（P<0.05）;经硫酸锌治疗8周后,维持性血液透析患者血清锌,GSH-Px、SOD活性升高,MDA水平下降,差异均有统计学意义（P<0.05）。结论 补锌可纠正血液透析患者血清锌缺乏,改善患者的氧化应激状态。     

四物汤对维持性血液透析患者微炎症状态的影响

目的观察四物汤对维持性血液透析(maintenance hemodialysis,MHD)患者微炎症状态的影响。方法选择符合入选标准的初诊血液透析患者40例,随机分为2组,即促红细胞生成素(Erythropoietin,EPO)组、四物汤与EPO组,分别以EPO、四物汤联合EPO进行治疗,在治疗第6、12周时检测患者血红蛋(hemoglobin,Hb)、C反应蛋白(C-reactie protein,CRP)和血清白细胞介素6(IL-6)的水平。结果四物汤与EPO组治疗第6、12周时血清CRP、IL-6水平较治疗前及EPO组明显降低(P<0.05,P<0.01),且第12周降低更为明显。尽管两组Hb皆有显著性提高(P<0.05,P<0.01),但以四物汤与EPO治疗组效果更为显著。结论四物汤能改善MHD患者微炎症状态,增加MHD患者EPO的疗效。     

血液透析滤过对血液透析患者微炎症状态的影响

目的 探讨血液透析滤过对血液透析患者微炎症状态的影响作用.方法 选取血液透析室维持性血液透析（maintenance hemodialysis,MHD）患者30例,随机分为观察组和对照组各15例.观察组采取血液透析联合血液透析滤过治疗,对照组采取血液透析治疗,观察并记录两组ALb、BUN、Scr、IL-6、TNF-α、hs-CRP的改善情况.结果 观察组患者透析12周后TNF-α、IL-6、hs-CRP均显著低于对照组,Alb则显著升高,两组比较差异均有统计学意义（P＜0.05）.结论 MHD患者采取血液透析滤过治疗,能够很好的改善患者的微炎症状态,提高患者生存质量.     

血液透析联合血液灌流对维持性血液透析患者微炎症状态的影响

目的研究血液透析联合血液灌流对维持性血液透析患者微炎症状态的影响。方法选择2012年12月至2013年10月来我院进行血液透析的60例终末期肾功能衰竭患者为研究对象,按照数字表随机分组的原则分为A组和B组各30例患者,其中A组A组采用血液透析+血液灌流的方法进行维透析,B组采用单纯血液透析进行治疗,观察两组治疗后6个月炎症指标和营养指标变化情况。结果治疗前后A组和CRP、TNF-α、IL-6、IL-8水平差值明显高于B组,差异均有显著的统计学意义(P<0.01);治疗前后A组治疗前后ALB、PAB、TF水平差值明显高于B组,差异均有显著的统计学意义(P<0.01)。结论血液透析+血液灌流能明显改善维持性血液透析患者体内微炎症状态,并间接地提高患者的营养水平值得临床推广应用。     

普罗布考对维持性血液透析患者氧化应激的影响

目的观察口服普罗布考对维持性血液透析(MHD)患者氧化应激的影响。方法选择20例透析时间超过3个月的MHD患者,口服普罗布考0.5 g/次,2次/d,服药8周。观察用药前后血浆丙二醛(MDA)、循环晚期氧化蛋白产物(AOPP)、超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)的含量。选择20例年龄、性别匹配的健康人作为对照组。结果与对照组比较,MHD患者血清MDA、AOPP含量升高(P<0.05),SOD、GSH-Px含量降低(P<0.05);应用普罗布考8周后,MHD患者血清MDA、AOPP含量明显降低(P<0.05),SOD、GSH-Px含量明显升高(P<0.05)。结论普罗布考明显改善MHD患者的氧化应激水平,短期应用无明显不良反应。     

水飞蓟素和维生素E对维持性血液透析患者氧化应激、炎症反应及血红蛋白的影响

目的探讨水飞蓟素和维生素E对维持性血液透析(MHD)患者氧化应激、炎症反应及血红蛋白的影响。方法选择80例维持性血液透析的患者,随机分为水飞蓟素组、维生素E组、联合组和对照组。水飞蓟素组口服水飞蓟素140 mg,3次/d;维生素E组口服维生素E软胶囊400 mg,1次/d;联合用药组口服水飞蓟素140 mg,3次/d,维生素E胶囊400 mg,1次/d;对照组予以安慰剂治疗。治疗前及治疗4周后,采血检测血清丙二醛(MDA)、C反应蛋白(CRP)、红细胞沉降率(ESR)及血红蛋白(HGB)水平。结果与对照组比较,治疗4周后,水飞蓟素组和联合组血清MDA、CRP和ESR水平明显降低,HGB水平明显上升(P<0.05)。结论水飞蓟素或水飞蓟素联合维生素E可以减轻MHD患者体内氧化应激及炎症反应水平,提高血红蛋白浓度。     

左卡尼汀治疗维持性血液透析患者微炎症及氧化应激状态

目的：通过观察静脉注射左卡尼汀对维持性血液透析（maintenance hemodialysis。MHD）患者营养、微炎症和氧化应激指标的影响。探讨左卡尼汀对MHD患者微炎症及氧化应激状态的治疗作用。方法：选择在上海市闸北区中心医院血液净化中心透析龄超过3个月的MHD患者62例，每次透析结束后，静脉注射左卡尼汀1g，进行为期6个月随访，分别检测治疗前、治疗1个月后、治疗6个月末患者的主要人体学指标、改良主观总体评价（SGA）评分、血生化指标、C反应蛋白（CRP）、白介素-6（IL-6）、白介素-1（IL-1）、肿瘤坏死因子-α（TNF-α）、血浆丙二醛（MDA）、血浆谷胱甘肽过氧化物酶（GSHPx）、血浆总高半胱氨酸（tHcy）、透析充分性（Kt／V）和蛋白质分解代谢率。结果：（1）治疗1个月后。MHD患者的透析后于体重、上臂肌围有上升；治疗6个月后，患者平均于体重、上臂肌围平均值较治疗前显著升高（P〈0．05）。改良SGA评分较治疗前明显下降（P〈0．01）。（2）治疗6个月后，MHD患者的血白蛋白（Alb）（P〈0．05）、前白蛋白（PA）和血红蛋白（Hb）（P〈0．01）较治疗前明显升高。（3）CRP、IL-6、TNF-α、MDA、tHcy的平均值均较治疗前明显下降（P（0．01）；GSHPx平均值较治疗前明显上升（P〈O．01）。（4）血总胆固醇、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇和脂蛋白（a）水平治疗前后无显著差异。（5）蛋白质分解代谢率较治疗前明显上升（P〈0．01）。Kt／V治疗前后无明显变化。结论：左卡尼汀可明显改善患者的营养状态．同时微炎症及氧化应激状态明显好转。     

血液透析串联血液灌流对维持性血液透析患者微炎症及血管内皮功能的影响

目的探讨血液透析串联血液灌流对维持性血液透析患者促炎因子及血管内皮功能的影响。方法我院透析中心血液透析患者25例。10例行单纯血液透析治疗,15例血液透析串联血液灌流治疗,选择10例健康人作为正常对照。观察与单纯血液透析相比,串连灌流治疗前、连续4次强化治疗后促炎因子TNF—a及VCAM一1的改变。结果维持性血液透析患者血中TNF—a、sVCAM-1的水平明显高于正常人。治疗前MHD患者血TNF—a与sVCAM-1水平呈显著正相关关系（r=0．674,P〈0．05）。患者血液透析串联血液灌流连续4次治疗后血中TNF—a、VCAM-1水平均明显下降。而单纯血液透析治疗组,TNF—a、sVCAM-1无明显改变。结论血液透析患者体内炎症状态可能导致了血管内皮功能损伤。血液透析串联血液灌流改善了患者体内微炎症状态并减轻血管内皮功能损伤。     

Potential effects of omega-3 fatty acids on anemia and inflammatory markers in maintenance hemodialysis patients

Background

Anemia is a common complication among hemodialysis (HD) patients. Although intravenous iron and erythropoiesis-stimulating agents revolutionized anemia treatment, about 10% of HD patients show suboptimal response to these agents. Systemic inflammation and increased serum hepcidin level may contribute to this hyporesponsiveness. Considering the anti-inflammatory properties of omega-3 fatty acids, this study aimed to evaluate potential role of these fatty acids in improving anemia and inflammation of chronic HD patients.

Methods

In this randomized, placebo-controlled trial, 54 adult patients with HD duration of at least 3 months were randomized to ingest 1800 mg of either omega-3 fatty acids or matching placebo per day for 4 months. Anemia parameters including blood hemoglobin, serum iron, transferrin saturation (TSAT), erythropoietin resistance index, and required dose of intravenous iron and erythropoietin, and serum concentrations of inflammatory/anti-inflammatory markers including interleukin (IL)-6, tumor necrosis factor (TNF)-α, IL-10, C-reactive protein (CRP), hepcidin, ferritin, intact parathyroid hormone (iPTH), and ratios of IL-10 to IL-6 and IL-10 to TNF-α were measured at baseline and after 4 months of the intervention.

Results

45 subjects (25 in the omega-3 and 20 in the placebo group) completed the study. No significant changes were observed in blood hemoglobin, serum iron, TSAT, and required dose of intravenous iron in either within or between group comparisons. Additionally, erythropoietin resistance index as well as required dose of intravenous erythropoietin showed no significant change in the omega-3 group compared to the placebo group. Although a relative alleviation in inflammatory state appeared in the omega-3 group, the mean differences of inflammatory and anti-inflammatory markers between the two groups did not reach statistically significant level except for IL-10-to-IL-6 ratio and serum ferritin level which showed significant changes in favor of omega-3 treatment (P <0.001 and P = 0.003, respectively).

Conclusion

Omega-3 fatty acids relatively improved systemic inflammation of chronic HD patients without any prominent benefits on anemia. However, future well-designed studies on larger number of patients may determine utility of omega-3 fatty acids in HD patients with respect to inflammation and anemia.     

PM2.5 collected in China causes inflammatory and oxidative stress responses in macrophages through the multiple pathways

Air pollution continues to increase in East Asia, particularly in China, and is considered to cause serious health problems. In this study, we investigated the toxicological properties of particulate matter ≤2.5 mm (PM_2.5) collected in an urban area in China (Shenyang), focusing on inflammation and oxidative stress tightly linked to respiratory diseases. Exposure to PM_2.5 significantly increased the expression levels of inflammatory (interleukin-1β and cyclooxygenase-2) and oxidative stress (heme oxygenase1) genes in the mouse macrophages. PM_2.5-caused inflammatory response was strongly suppressed by endotoxin neutralizer (polymyxin B) and knock-out of toll-like receptor 4, while oxidative stress was not. On the other hand, an antioxidant (N-acetylcystein) suppressed oxidative stress, but not inflammatory response. These results suggest that PM_2.5 in the atmospheric environment of China causes inflammation and oxidative stress in macrophages via separate pathways.     

Effects of vitamin B-6 supplementation on oxidative stress and inflammatory response in neonatal rats receiving hyperoxia therapy

Hyperoxia is often used in the treatment of neonates. However, protracted use of hyperoxia leads to significant morbidity. The purpose of this study was to evaluate the effects of vitamin B-6 supplementation on oxidative stress and inflammatory responses in neonatal rats undergoing hyperoxia therapy. The study consisted of 2 parts: a survival study and a vitamin B-6 efficacy study for 16 days. Neonatal rats were randomly divided into either the control group, B-6 group (subcutaneously injected with 90 mg/kg/d of pyridoxal 5′-phosphate [PLP]), O₂ group (treated with 85% oxygen), or O₂ + B-6 group (simultaneously treated with 85% oxygen and 90 mg/kg/d PLP). After the survival study was done, the vitamin B-6 efficacy study was performed with duplicate neonatal rats sacrificed on the 3rd, 6th, 9th, and 16th day. Serum inflammatory cytokines, tissue pathology, and malondialdehyde (MDA) levels were measured. In the survival study, the survival rate of neonatal rats in the control, B-6, O₂, and O₂ + B-6 group on the 16th day were 100%, 100%, 25%, and 62.50%, respectively. The efficacy study showed lung polymorphonuclear granulocyte (PMN) and macrophage infiltration, increased liver hemopoiesis, and higher MDA levels in liver homogenates at days 3 through 16 in the O₂ group. Vitamin B-6 supplementation considerably increased serum inflammatory cytokines in either the 6th or 9th day and decreased liver MDA level before the 6th day. These results indicate that neonatal rats receiving hyperoxia treatment suffered divergent serum inflammatory responses and were in increased liver oxidative stress. Vitamin B-6 supplementation seemed to improve survival rates, change systemic inflammatory response, and decrease liver oxidative stress while neonatal rats were under hyperoxia treatment.     

Lycopene and resveratrol ameliorate zinc oxide nanoparticles-induced oxidative stress in Nile tilapia,Oreochromis niloticus

Industrial products contained nano-zinc oxide (ZnONP) can gain access to the aquaculture environment causing hazardous effects on the living biota. Therefore, this work was planned to examine the ameliorative effects of dietary supplementation of lycopene (LYC) and/or resveratrol (RES) against ZnONP toxicity in Nile tilapia. Five groups with 20 fish each were used; Control, received tap water only; ZnONP group, was intoxicated with ZnONP (50 mg/L); ZnONP-LYC group, was exposed to ZnONP and LYC (500 mg/ kg of the diet); ZnONP-RES group, was exposed to ZnONP and RES (50 mg/kg of the diet); ZnONP-LYC-RES group, was exposed to ZnONP and a combination of LYC and RES. The experiment was continued for 30 days. Fish blood and tissues were then assembled for determination of liver and kidney function and oxidative stress status in liver, kidney, and gills tissue. Results revealed a considerable elevation of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cholesterol, urea, and creatinine with a noticeable lowering of total proteins and albumin serum levels in response to ZnONP intoxication. In addition, there were significant increase in malondialdehyde (MDA) and reduction in the reduced-glutathione (GSH) levels and superoxide dismutase (SOD) and catalase (CAT) activities. However, treatment with LYC and/or RES ameliorated the ZnONP-inflicted oxidative stress which possibly attributed to their beneficial antioxidant activities.     

麝香保心丸治疗维持性血液透析患者无症状心肌缺血的疗效观察

目的 观察麝香保心丸治疗维持性血液透析患者无症状心肌缺血的临床疗效,探讨其作用机制.方法 78例维持性血液透析并发无症状心肌缺血患者按随机数字表法分为对照组(38例)和麝香保心丸组(40例).78例患者达到充分透析标准后,对照组给予常规治疗.麝香保心丸组在对照组治疗基础上加服麝香保心丸45 mg,3次/d;2组疗程均为2个月.2组治疗前后于透析前1天测量血压、心率,查血清肌酐、尿素氮、空腹血糖、TC、TG、HDL-C、LDL-C、高敏C反应蛋白(hs-CRP)、白细胞介素(IL)-6和血常规,并于治疗前后透析前完成24h动态心电图监测,记录患者心肌缺血发作次数和心肌缺血持续时间.结果 ①治疗后麝香保心丸组和对照组患者血清hs-CRP、IL-6水平较治疗前均明显降低[(4.7±1.5)mg/L比(9.7±4.2)mg/L,(5.7±1.5)mg/L比(9.8±4.4) mg/L; (53±24) ng/L比(88±28) ng/L,(67±26) ng/L比( 89±27) ng/L,均P＜0.01];麝香保心丸组降低更明显,2组比较差异有统计学意义(P＜0.01).②治疗后麝香保心丸组和对照组患者无症状心肌缺血发作次数减少[(14.7±4.7)次/24 h比(22.8±7.8)次/24 h,(18.7±5.8)次/24 h比(23.5±6.9)次/24 h]、缺血持续时间明显缩短[(65.4±15.2) min比(128.1±37.3)min,(78.6±13.8)min比(131.1±35.4)min],麝香保心丸组改善更明显,2组之间差异有统计学意义(P＜0.01).③治疗后患者收缩压明显降低(P＜0.05),但2组之间差异均无统计学意义(P＞0.05);舒张压、心率、血脂、空腹血糖、肌酐水平及贫血程度有所改善,但2组之间差异无统计学意义(P＞0.05).结论 麝香保心丸治疗维持性血液透析患者无症状心肌缺血具有良好的临床疗效,机制可能与抑制炎症反应有关.