炎症细胞因子与心肾贫血综合征的关系：重组人促红细胞生成素（rhepo）治疗

Relationship between inflammatory cytokines and cardiorenal anemia syndrome: treatment with recombinant human erythropoietin (rhepo).

作者信息

Perunicic-Pekovic G, Pljesa S, Rasic Z, Komadina L J, Markovic R, Lambic L J, Celeketic D

机构信息

Department of Nephrology, University Hospital Zemun-Belgrade, Belgrade, Serbia.

出版信息

Hippokratia. 2008 Jul;12(3):153-6.

PMID:18923748

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2504408/

Abstract

BACKGROUND AND AIM

Hemodialysis (HD) patients are exposed to persistent inflammatory state. Erythropoietin resistance is known to be strongly associated with chronic inflammation. Aim of the study was to analyze the effect of elevated inflammatory markers on hemoglobin levels and rhEPO requirements in stable patients of our hemodialysis center.

PATIENTS AND METHODS

The study population consisted of 42 patients, 19F/23M, mean age 54.5+/-12.0 years. C-reactive protein (CRP), interleukin-6 (IL-6), hemoglobin (Hb), ferritin and left ventricular mass index (LVMi) were recorded. Group 1 consisted of 10 patients with Hb<or=10 g/dl, mean 8.3+/-1.2 g/dl and Group 2, of 10 patients with Hb>or=10 g/dl, mean 12.6+/-1.91 g/dl. None of these 20 patients had been previously treated with rhEPO. Group 3 consisted of 22 patients with mean Hb 10.1+/-1.5 g/dl after treatment with rhEPO.

RESULTS

Group 1 patients had significantly higher IL-6 concentrations than Group 2 (5.21+/-3.94 vs 3.03+/-3.64, p<0.03). Group 3, treated with rhEPO had IL-6 concentrations significantly lower compared to Group 1 (1.15+/-3.81 vs 3.03+/-3.64, p<0.05). HD pts in Group 1 presented significantly higher CRP concentrations compated to pts of Group 2 and 3 (23.1+/-9.1 vs 7.02+/-8.7 and 7.89+/-9.6 respectively, p<0.05). A negative correlation was demonstrated between IL-6 and Hb level (r: 0.33 p<0.05).

CONCLUSIONS

A better management of anemia might improve inflammatory state and survival in this population.

摘要

背景与目的

血液透析（HD）患者处于持续炎症状态。已知促红细胞生成素抵抗与慢性炎症密切相关。本研究的目的是分析炎症标志物升高对我们血液透析中心稳定患者血红蛋白水平和重组人促红细胞生成素（rhEPO）需求的影响。

患者与方法

研究人群包括42例患者，19例女性/23例男性，平均年龄54.5±12.0岁。记录了C反应蛋白（CRP）、白细胞介素-6（IL-6）、血红蛋白（Hb）、铁蛋白和左心室质量指数（LVMi）。第1组由10例Hb≤10 g/dl的患者组成，平均为8.3±1.2 g/dl；第2组由10例Hb≥10 g/dl的患者组成，平均为12.6±1.91 g/dl。这20例患者此前均未接受过rhEPO治疗。第3组由22例接受rhEPO治疗后平均Hb为10.1±1.5 g/dl的患者组成。

结果

第1组患者的IL-6浓度显著高于第2组（5.21±3.94对3.03±3.64，p<0.03）。接受rhEPO治疗的第3组患者的IL-6浓度显著低于第1组（1.15±3.81对3.03±3.64，p<0.05）。第1组的血液透析患者的CRP浓度显著高于第2组和第3组患者（分别为23.1±9.1对7.02±8.7和7.89±9.6，p<0.05）。IL-6与Hb水平之间呈负相关（r：0.33，p<0.05）。