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[接受重组人促红细胞生成素治疗的血液透析患者血液流变学参数的改善]

[Improvement of hemorheologic parameters in hemodialyzed patients treated with human recombinant erythropoietin].

作者信息

Delamaire M, Durand F, Hamel D, Joyeux V, Lepogamp P, Genetet B

机构信息

Centre Régional de Transfusion Sanguine-Rennes.

出版信息

J Mal Vasc. 1991;16(3):289-94.

PMID:1940657
Abstract

Recombinant human erythropoietin (rhu EPO) is the choice treatment of dialytic anemia; however, this therapy has side effects due to the increased number of blood components involved. It seemed to us worth assessing, by hemorheological study, the impact of such a treatment on blood flow properties, already impaired in this type of patients. This study was designed to measure the evolution of hemorheological parameters in 16 hemodialysed patients before and after 2.3 and 6 months of treatment with rhu EPO. Hemorheological work-ups included: erythrocyte filtration with a hemorheometer; blood and plasma viscosities (LS30), ATP and 2.3 DPG, RBC aggregation (Sefam erythroaggregameter), RBC morphology under a scanning electron microscope; blood counts and full biochemical work-ups were performed to explore renal function. The results showed, besides a significant increase in hemoglobin: normalized rigidity index, reflecting the better deformability of erythrocytes; a moderate increase in blood viscosity with uncorrected hematocrit, becoming significant after 6 months of treatment. This increase however did not reach the values that could be expected with the increased hematocrit (it was probably balanced by improved erythrocyte deformability, which is confirmed by the fact that with corrected hematocrit, blood viscosity decreases during treatment). Studying erythrocyte aggregation in hemodialysed patients reveals, in the absence of any treatment, a decrease in aggregation time and a higher dissociation threshold, which reflects a tendency to erythrocyte hyperaggregation enhanced by erythropoietin.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

重组人促红细胞生成素(rhu EPO)是透析性贫血的首选治疗方法;然而,这种疗法因涉及的血液成分数量增加而有副作用。在我们看来,通过血液流变学研究评估这种治疗对血液流动特性的影响是值得的,而这类患者的血液流动特性已经受损。本研究旨在测量16例血液透析患者在接受rhu EPO治疗2.3个月和6个月前后血液流变学参数的变化。血液流变学检查包括:用血液流变仪进行红细胞过滤;测量血液和血浆粘度(LS30)、三磷酸腺苷(ATP)和2,3-二磷酸甘油酸(2.3 DPG)、红细胞聚集性(Sefam红细胞聚集仪)、扫描电子显微镜下的红细胞形态;进行血细胞计数和全面的生化检查以评估肾功能。结果显示,除血红蛋白显著增加外:标准化刚性指数反映红细胞变形性更好;未校正血细胞比容时血液粘度适度增加,治疗6个月后变得显著。然而,这种增加未达到血细胞比容增加时预期的值(可能被改善的红细胞变形性所平衡,这一点可由以下事实证实:校正血细胞比容后,治疗期间血液粘度降低)。对血液透析患者红细胞聚集性的研究表明,在未进行任何治疗时,聚集时间缩短且解离阈值更高,这反映了促红细胞生成素增强的红细胞过度聚集倾向。(摘要截断于250字)

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