The Serum Levels Of Heme Oxygenase-1 And Inflammatory Factors In Hemodialysis Patients

Objectives To measure the level of heme oxygenase-1(HO-1) and to explore the relativity between heme oxygenase-1 and malondialdehyde(MDA), C-reactive protein(CRP) interleukin-6(IL-6) before and after hemodialysis in hemodialysis patients.Methods The patients group:Thirty chronic renal failure patients treated by routine hemodialysis were selected in the Blood Purification Center,Affiliated hospital of Qinghai university from June to October 2010, Inclusion criteria:â‘ their hemodialysis time was more than three months,â‘¡they had no infection,malignant tumor,active bleeding,autoimmune diseases and so on,â‘¢they had no biood transfusion and surgery history in three months,â‘£they unused immunosuppressant, Iron agent, vitamin C or E, and they agreed to participate in the experiment. All patients were subjected to hemodialysis by 4008S briefcase sized dialysis machine,Fei Sen especial dialysate, Gather suplphone membrane(all were not used repeatly),bicarbonate dialysate,dialysate's flow is 500ml every minute,blood's flow is 250~300ml every minute,Vascular access were autologous arteriovenous fistula or internal jugular venous catheter(uninfected), heparin and low molecular heparin were to anticoagulate,Every dialysis time is 4 hours and 2-3 times per week internal arteriovenous fistula. The control group:Twenty-six physical examines matched with age and gender,normal liver and renal function,no heart of lung diseases were selected from medical center in affiliated hospital of Qinghai university. Laboratory tests: The venous blood of patients was harvested for biochemical indicator detection in patients group and control group, the patients group harvested venous blood again to test index after hemodialysis. Heme oxidase-1 level was estimated by ELISA and malondialdehyde by TBA to evaluate oxidative stress state,C-reactive protein was detected by the immune turbidity method,interleukin-6 was estimated by ELISA to evaluate chronic inflammation and elimination.,and analysis their relativity.Results1. The HO-1,MDA,CRP and IL-6 levels in the patients before and after hemodialysis were obviously higher than the control group(P<0.01);compared after hemodialysis with before hemodialysis.The HO-1,MDA,CRP and IL-6 level in after hemodialysis were increased (P<0.05).2. The HO-1 of hemodialysis patients had positively correlation with MDA and CRP(the correlation coefficient were 0.516 and 0.447, P<0.001),MDA had positively correlation with CRP and IL-6(the correlation coefficient were 0.752 and 0.626, P<0.001).Condusions1. The HO-1,MDA,CRP and IL-6 levels in the patients before and after hemodialysis were obviously higher than the control group,it showed that Oxidative Stress and inflammation existed in hemodialysis patients.These indexs were increased in after hemodialysis, because of dialysis membrane's uncompatibility, macrophages's activation,dialysis water's harmful substances of potential and so on.The process of hemodialysis aggravate oxidative stress and inflammation.2. The MDA of hemodialysis patients had positively correlation with CRP and IL-6,which show Oxidative Stress and nflammation themselves interacted; The HO-1 of hemodialysis patients had positively correlation with MDA and CRP, which showed that the compensatory increase of HO-1 level was in response to oxidative stress and inflammation.3. HO-1 is one of the most widespread antioxidant defense enzymes,it can inhibit inflammation and protect vascular endothelial cells,which are prevent the oxidative damage. HO-1's increasing is a decompensation of reaction for Oxidative stress and inflammatory condition, which can predict the level of oxidatie stress and inflammation . But the hemodialysis patients'oxidatie stress and inflammatory state are mixed by many complicated factors, So only HO-1 is not enough to improve the oxidatie stress and inflammatory levels.