【作者】 张聪；

【导师】 邵凤民； 汪涛；

【作者基本信息】 郑州大学 ， 内科学， 2010， 硕士

【摘要】 目的研究口服抗氧化剂维生素E对持续非卧床腹膜透析(CAPD)患者氧化应激及微炎症状态的影响,以及对CAPD患者血管内皮功能的改善作用。方法选择2008年7月至2009年6月在北京大学第三附属医院肾内科透析中心透析时间超过3个月的CAPD患者50例,治疗组34例口服维生素E 400 mg/d,未治疗组16例未口服维生素E,选择15名健康者作对照组。服药6周后,观察用药前后血浆中维生素E及血浆丙二醛(MDA)、循环晚期氧化蛋白产物(AOPP)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)等氧化应激指标以及血浆C-反应蛋白(CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)等炎症指标的变化。另外选择血流介导的血管舒张功能(FMD)做为血管内皮功能指标,研究抗氧化治疗对血管内皮功能的保护作用。结果口服维生素E 400 mg/d治疗六周后,治疗组患者MDA、AOPP较治疗前明显降低(P<0.05),维生素E、SOD活性、GSH-PX活性较治疗前升高(P<0.05),炎症指标CRP和TNF-α较治疗前明显降低(P<0.05),血管内皮功能较治疗前有改善,FMD较前明显升高(P<0.05),IL-6水平较治疗前有所降低,但治疗前后差异无统计学意义(P>0.05)。结论口服维生素E(400 mg/d)可以改善CAPD患者的氧化应激状态；并且可以部分抑制患者的微炎症状态；改善血管内皮功能。短期应用大剂量维生素E未见明显副反应。更多还原

【Abstract】 Objective:To investigate the influence of Vitamin E on the oxidative stress, micro-inflammation and the effects of vitamin E on improving vascular endothelial function in patients with CAPD(continuous ambulatory peritoneal dialysis) and the safety of Vitamin E supplementation in these patients.Method:Fifty patients with CAPD and fifteen healthy volunteers were involved in this study. Thirty-four patients were administered 400mg/d of Vitamin E for 6 weeks. Sixteen patients were not administered Vitamin E. The levels of vitamin E (Vit E),malondialdehyde (MDA),advanced oxidation protein product (AOPP) superoxide dismutase(SOD),activity of glutathione peroxidase (GSH-PX) microinflammation cytokines C-reactive protein (CRP),interleukin-6(IL-6) interleukin-10(IL-10) and tumor necrosis factor(TNF-α) in plasma were measured at the beginning and the end of administering Vit E. The levels of flow mediated dilatation (FMD) were measured simultaneously to learn the protection of antioxidant treatment to endothelial function. Results:400mg/d of Vit E supplementation of six weeks decrease the levels of plasma MDA, AOPP, CRP, TNF-a(P<0.05),while the level of Vit E, SOD, GSH-PX, FMD were increased (P<0.05).The plasma levels of IL-6 were reduced but there were no significant change.(p>0.05).Conclusion:There are oxidative stress and microinflammation state in patients with CAPD. 400 mg/d of VitE ameliorates oxidative stress and micro-inflammation state and vascular endothelial function without apparent side effect, although farther observation are needed.更多还原