VitE对MHD患者静脉补铁诱导的氧化应激及脂代谢紊乱的影响(1)
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【摘要】 目的 探讨口服维生素(VitE)对静脉补铁诱导的氧化应激及脂质代谢紊乱的影响。方法 选择维持性血液透析合并肾性贫血患者40例随机分为静脉补铁组及静脉补铁加VitE组,每组20例,另设健康对照20例。静脉补铁组:行血液透析治疗时由静脉输入100 mg蔗糖铁注射液,起始为每周2～3次,完成总剂1000 mg后改为每周或2周一次,使患者的铁蛋白维持在100～300ug/L之间。静脉补铁加VitE组:除按上述方法补铁外同时口服VitE200 mg,2次/d。两组患者同时使用促红素治疗(100～150 U/kg•w)。检测三组治疗前和补铁组、补铁+VitE组治疗1个月及6个月血脂及氧化应激指标。结果 治疗1个月,补铁组与治疗前比较MDA、AOPP、TCH、Lp(a)、ApoB含量升高(P<0.05),SOD、GSH-Px 、ApoA1含量降低(P0.05)。治疗6个月,补铁+VitE组与补铁组比较SOD、GSH-Px 、ApoA1明显升高,AOPP、MDA、TCH、Lp(a)、ApoB明显降低(P<0.05),TG、LDL、HDL、VLDL无明显变化(P>0.05)。 结论 静脉补铁可以加重MHD患者体内的氧化应激水平及脂代谢紊乱。长时间口服维生素E可以改善MHD患者静脉补铁诱导的氧化应激及脂代谢紊乱。
【关键词】氧化应激;脂代谢紊乱; 静脉补铁; 维生素E;MHD
Effects of vitamin E on oxidative stress and disturbance of lipid metabolism induced by intravenous iron infusion in maintenance hemodialysis patients
【Abstract】 Objective To examine the effects of vitamin E as an antioxidant on oxidative stress and disturbance of lipid metabolism induced by intravenous iron sucrose infusion in treatment of anemia of MHD patient.Methods 40 MHD patients were selected and randomly divided into intravenous iron group(n=20) and intravenous iron+vitamin E group(n=20) compared with 20 healthy people.Intravenous iron group: 100 mg iron sucrose rejectionswere used while the patients accepted hemodialysis。At the beginning patients received iron two or three times every week until complete the total dose of 1000 mg, later the patients received iron treatment every one or two weeks made the serum ferritin maintained at between 100 ug/L to 300ug/L.Intravenous iron+vitamin E group : same with the first group and add oral VitE 200 mg, two times one day,Erythropoietin(EPO) was used at a dose of 100-150U/(kg•w) by hypodermic in each group.TG,TCH,LDL,VLDL,HDL,Lp(a),ApoB,SOD,MDA,AOPP,GSH-Px were tested in each group at the beginning and with treatment of 1 and 6 months later.Results Iron treatment for 1 month MDA,AOPP,TCH,Lp(a),ApoB increased (P<0.05) but GSH-Px,SOD,ApoA1 activity decreased (P<0.05) than those pretherapy in iron group. No significant changed in TG,LDL,VLDL,HDL ( P>0.05) Vitamin E treatment for 1 month serum SOD,GSH-Px of intravenous iron+vitamin E group increased slightly compared with iron group (P>0.05), AOPP,MDA activity were slightly lower than that in controls.But there were no significant difference both.TG,LDL,HDL,VLDL ApoA1,ApoB、Lp(a)had no significant changes also.(P>0.05).But TCH decreased obviously(P<0.05).Vitamin E treatment for 6 month serum SOD,GSH-Px and ApoA1 became higher significantly, AOPP,MDA TCH,Lp(a),and ApoB activity were obviously lower (P<0.05) compared with iron group.No significant changes in TG,LDL,HDL,VLDL(P>0.05).Conclusion MHD patients with higher levels of oxidatives and Lipid metabolism disorders compared with the normal.Intravenous iron can aggravate the situation.Oral of 200 mg vitamin E for long term can attenuate oxidative stress and lipid metabolism disorders induced by Intravenous iron.
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