Davenport A, Will E J, Khanna S K, Davison A M
Department of Renal Medicine, St. James's University Hospital, Leeds, UK.
Am J Nephrol. 1992;12(5):357-62. doi: 10.1159/000168472.
The effect of increasing haemoglobin by erythropoietin therapy on exercise capacity was investigated in 11 regular haemodialysis patients, previously transfusion dependent. Exercise work load increased from a median of 100 W (95% confidence limit, 25-135) to 120 (45-180; p < 0.05) following erythropoietin, and the duration of the exercise test from 13 (3.5-20) to 15.5 min (4-22; p < 0.05). Resting blood lactate concentration decreased from 0.8 (0.6-1.6) to 0.3 mmol/l (0.3-0.4), p < 0.05, following treatment with erythropoietin, as did blood lactate concentration at maximal exertion from 2.0 (1.0-4.1) to 1.8 mmol/l (0.5-2.8; p < 0.05). In association with the increase in haemoglobin from a median of 6 (5.1-6.8) to 11.1 g/dl (11-11.9) following erythropoietin therapy, patients were able to achieve greater exercise capacity both in terms of maximum work load and duration of exercise in association with a reduced resting arterial lactate and a similar exercise-induced lactate production. This suggests that treatment had improved muscle function in terms of lactate production and/or utilisation. This was probably due to the increase in tissue oxygen delivery, as there was an increase in the median arterial oxygen content from 79 (65-85) to 150 ml O2 (144-157) following erythropoietin treatment.
在11名既往依赖输血的维持性血液透析患者中，研究了促红细胞生成素治疗提高血红蛋白水平对运动能力的影响。促红细胞生成素治疗后，运动负荷从中位数100瓦（95%置信区间，25 - 135）增加到120瓦（45 - 180；p < 0.05），运动试验持续时间从13分钟（3.5 - 20）增加到15.5分钟（4 - 22；p < 0.05）。促红细胞生成素治疗后，静息血乳酸浓度从0.8（0.6 - 1.6）降至0.3 mmol/L（0.3 - 0.4），p < 0.05，最大运动时的血乳酸浓度也从2.0（1.0 - 4.1）降至1.8 mmol/L（0.5 - 2.8；p < 0.05）。促红细胞生成素治疗后，血红蛋白从中位数6（5.1 - 6.8）g/dl增加到11.1（11 - 11.9）g/dl，患者在最大工作负荷和运动持续时间方面能够实现更大的运动能力，同时静息动脉血乳酸降低，运动诱导的乳酸生成相似。这表明治疗在乳酸生成和/或利用方面改善了肌肉功能。这可能是由于组织氧输送增加，因为促红细胞生成素治疗后动脉血氧含量中位数从79（65 - 85）增加到150 ml O2（144 - 157）。
