慢性肾脏病患者低分子肝素抗氧化作用的研究

刘晓燕; 钟一红; 丁小强

doi:10.3969/j.issn.1671-4091.2011.03.00

中国血液净化 >

2011 , Vol. 10 >Issue 3: 129 - 132

DOI: https://doi.org/10.3969/j.issn.1671-4091.2011.03.00

临床研究

慢性肾脏病患者低分子肝素抗氧化作用的研究

刘晓燕 ,
钟一红 ,
丁小强

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复旦大学附属中山医院肾内科, 大连医科大学附属第二医院肾内科

收稿日期: 2010-09-06

修回日期: 1900-01-01

网络出版日期: 2011-03-12

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The effect of low molecular weight heparin as an antioxidant in chronic kidney disease

LIU Xiao-yan ,
ZHONG Yi-hong ,
DING Xiao-qiang

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1Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai 200032, China; 2Department of Nephrology, the Second Affiliated Hospital of Dalian Medical University, Dalian 116027, China

Received date: 2010-09-06

Revised date: 1900-01-01

Online published: 2011-03-12

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摘要

【摘要】目的阐明在慢性肾脏病(chronic kidney disease,CKD)时低分子肝素是否具有抗氧化作用，为临床治疗提供理论依据。方法选取CKD 3～5期住院患者40例，随机分为低分子肝素(low molecular weight heparin，LMWH)组(速碧林0.4 ml/d皮下注射，连续10 d)及还原型谷胱甘肽(reduced glutathione，GSH)组(泰特1.8 g/d加入0.9% NaCl溶液静脉滴注，连续10 d)。测定2组用药前后血浆氧化应激指标谷胱甘肽过氧化物酶(glutathione peroxidase,GSH-PX)、丙二醛(malondialdehyde,MDA)、晚期氧化蛋白产物(advanced oxidation protein products,AOPP)，并观察药物不良反应。结果 LMWH及GSH治疗后血浆AOPP水平均显著降低(P＜0.05)，GSH组AOPP降低值显著高于LMWH组，分别为(4.89±0.66)靘ol/L和(2.86±0.82)靘ol/L，差异有统计学意义(P＜0.05)；LMWH及GSH治疗后GSH-PX活力均显著升高(P＜0.05),LMWH组和GSH组GSH-PX升高值分别为(3.55±1.01)×104 U/L和(4.77±1.78)×104 U/L，差异无统计学意义(P＞0.05)；LMWH治疗前后MDA分别为(5.54±1.66)nmol/ml和(5.42± 1.40)nmol/ml，差异无统计学意义(P＞0.05)，GSH治疗后MDA活力比治疗前显著降低，分别为(5.09±1.44)nmol/ml和(4.61±1.30)nmol/ml，差异有统计学意义(P＜0.05)。两组药物治疗期间均未见明显不良事件。结论 LMWH可以改善CKD患者氧化应激状态，短期应用未见明显不良反应。与GSH相比，LMWH的抗氧化作用稍弱。

关键词： 氧化应激; 慢性肾脏病; 低分子肝素; 还原型谷胱甘肽

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刘晓燕 , 钟一红 , 丁小强 . 慢性肾脏病患者低分子肝素抗氧化作用的研究[J]. 中国血液净化, 2011 , 10(3) : 129 -132 . DOI: 10.3969/j.issn.1671-4091.2011.03.00

Abstract

Objective To identify the anti-oxidative effect of low molecular weight heparin (LMWH) in chronic kidney disease (CKD). Method Forty CKD patients at stage 3-5 were randomly divided into two groups, glutathione (GSH) group (0.9% NaCl 250ml + Glutathione 1.8g/d, intravenous injection for 10 days) and LMWH group (Fraxiparine 0.4ml/d, subcutaneous injection for 10 days). Plasma malondialdehyde (MDA), advanced oxidation protein product (AOPP) and glutathione peroxidase activity (GSH-PX) were measured at the beginning and the end of glutathione or LMWH administration. Results Plasma AOPP decreased and plasma GSH-PX increased significantly after the treatment in both LMWH and GSH groups (P<0.05). The decrease of plasma AOPP was more significant in GSH group than in LMWH group (2.86±0.82 vs. 4.89±0.66μmol/l, P<0.05). After the treatment, plasma MDA did not change significantly in LMWH group, but decreased (5.09±1.44 vs. 4.61±1.30nmol/ml, P<0.05) in GSH group. There were no apparent side effects in both groups. Conclusion LMWH ameliorates oxidative stress state without apparent side effects. The anti-oxidative effect of LMWH is slightly lower than that of GSH.

Key words： Chronic kidney disease; Low molecular weight heparin; Reduced glutathione

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