上海交通大学学报（医学版）

›› 2010, Vol. 30 ›› Issue (9): 1149-.doi: 10.3969/j.issn.1674-8115.2010.09.031

• 论著（临床研究） • 上一篇    下一篇

硫辛酸预处理对腹膜透析患者静脉铁剂治疗诱导的氧化应激反应的影响

王 沛, 刘章锁, 梁献慧   

  1. 郑州大学 |第一附属医院肾内科, 郑州 450052
  • 出版日期:2010-09-25 发布日期:2010-09-27
  • 作者简介:王 沛（1977—）, 男, 博士, 主治医师；电子信箱: wangpei146@sina.com。

Effects of lipoic acid pretreatment on oxidative stress induced by intravenous iron supplement in patients with peritoneal dialysis

WANG Pei, LIU Zhang-suo, LIANG Xian-hui   

  1. Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, China
  • Online:2010-09-25 Published:2010-09-27

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摘要：

目的 观察硫辛酸预处理对持续性不卧床腹膜透析（CAPD）患者接受静脉铁剂治疗诱导的急性氧化应激反应的影响。方法 40例CAPD患者先后接受单纯静脉铁剂治疗（Fe组）和先给予硫辛酸静脉滴注后的静脉铁剂治疗（Lipoic+Fe组），两次治疗间隔8周以上；分别于静脉铁剂滴注前（0时点）和滴注后10、60、120、240 min时点采集血样，可见光分光光度计测定血清超氧化物歧化酶（SOD）和谷胱甘肽过氧化物酶（GSH-Px）活性及血清丙二醛（MDA）水平。以20名健康志愿者作为正常对照组。结果 与正常对照组相比，Fe组和Lipoic+Fe组0时点血清SOD和GSH-Px活性降低，MDA水平升高（P<0.05）。Fe组和Lipoic+Fe组静脉补铁后，血清SOD和GSH-Px活性下降，MDA水平升高，分别于60 min时点达到谷值或峰值。Lipoic+Fe组各时点血清SOD和GSH-Px活性均显著高于Fe组（P<0.05），MDA水平均显著低于Fe组（P<0.05）。结论 静脉补铁可使CAPD患者的氧化应激状态急性加重；预防性应用硫辛酸可在一定程度上减轻静脉铁剂诱导的氧化应激反应。

关键词: 氧化应激, 腹膜透析, 静脉铁剂, 硫辛酸

Abstract:

Objective To observe the effects of lipoic acid pretreatment on acute oxidative stress induced by intravenous iron supplement in patients with continuous ambulatory peritoneal dialysis (CAPD). Methods Forty patients with CAPD received single intravenous iron supplement (Fe group) and intravenous iron supplement with lipoic acid pretreatment (Lipoic+Fe group), and the intermission between these two treatment was more than 8 weeks. Blood samples were taken before (0 min) and 10, 60, 120 and 240 min after intravenous iron supplement, and the activity of serum superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) and level of serum malondiadehyde (MDA) were detected by visible range spectrophotometer. Another 20 healthy volunteers were served as control group. Results Compared with control group, the activity of SOD and GSH-Px in Fe group and Lipoic+Fe group at 0 min time point decreased, while the level of MDA increased （P<0.05）. After intravenous iron supplement in two groups, the activity of SOD and GSH-Px decreased and reached the valley at 60 min time point, and the level of MDA increased and reached the peak at 60 min time point. The activity of SOD and GSH-Px was significantly higher and the level of MDA was significantly lower at each time point in Lipoic+Fe group than those in Fe group (P<0.05). Conclusion Acute aggravation of oxidative stress may be induced by intravenous iron supplement in patients with CAPD, which may be alleviated by lipoic acid pretreatment.

Key words: oxidative stress, peritoneal dialysis, intravenous iron supplement, lipoic acid