Tetta C, Biasioli S, Schiavon R, Inguaggiato P, David S, Panichi V, Wratten M L
Clinical and Laboratory Research Department at Bellco, Bellco SpA, Mirandola, Italy.
Blood Purif. 1999;17(2-3):118-26. doi: 10.1159/000014383.
Today's patient population is increasingly older. Patients with chronic renal failure therefore start extracorporeal substitutive treatment having congestive heart failure, chronic liver disease, diabetes and so forth. In these patients, however, long-term haemodialytic treatment may add further aggravation on their pre-existing pathological conditions. Oxidative stress and alterations in lipid metabolism are caused by haemodialysis mainly due to (1) bioincompatibility type of reactions such as production of reactive oxygen species by inflammatory cells due to complement-mediated or -independent pathways, and (2) the imbalance between oxidants and antioxidants due to the diffusive loss of hydrophilic vitamins such as ascorbic acid. The events related to the oxidant stress may sustain a state of chronic inflammation. Recent advances suggest that atherosclerosis and proliferation of the smooth muscle are initiated and sustained by inflammatory mechanisms. Therefore, attempts to counterbalance the prooxidant effect of haemodialysis and to reduce the chronic inflammatory state will be presented.
如今的患者群体年龄越来越大。因此，慢性肾衰竭患者开始接受体外替代治疗时往往伴有充血性心力衰竭、慢性肝病、糖尿病等病症。然而，对于这些患者而言，长期血液透析治疗可能会使他们原有的病理状况进一步恶化。血液透析会引发氧化应激和脂质代谢改变，主要原因如下：（1）生物不相容性反应，例如炎症细胞通过补体介导或非补体介导途径产生活性氧；（2）亲水性维生素（如抗坏血酸）因扩散流失导致氧化剂与抗氧化剂之间失衡。与氧化应激相关的事件可能会维持慢性炎症状态。最近的研究进展表明，动脉粥样硬化和平滑肌增殖是由炎症机制引发并维持的。因此，本文将介绍一些旨在抵消血液透析促氧化作用并减轻慢性炎症状态的尝试。
