Grimm G, Stockenhuber F, Schneeweiss B, Madl C, Zeitlhofer J, Schneider B
1st Department of Medicine, University of Vienna, Austria.
Kidney Int. 1990 Sep;38(3):480-6. doi: 10.1038/ki.1990.229.
To evaluate the effects of recombinant human erythropoietin (rHuEPO) on brain function, 15 chronic hemodialysis patients were studied by event-related P300, stimulus-related evoked potentials, and trailmaking before (hematocrit 22.7%) and after rHuEPO (hematocrit 30.6%). P300 peak latency elicited by a tone discrimination paradigm improved (391 before vs. 366 ms after; Cz = vertex; P less than 0.01) confirming beneficial effects on cerebral cognitive processing. P300 amplitude (13.6 vs. 15.8 microV; P = 0.06) and trailmaking tended to improve (55 vs. 43 s). P300 measures were influenced by low hemoglobin levels before rHuEPO (P less than 0.01), suggesting that severe anemia may contribute to uremic brain dysfunction. Furthermore, decrease of stimulus-related auditory brainstem I-V interpeak latency (4.28 before vs. 4.17 ms after; P less than 0.05) and increase of somatosensory N20/P25 amplitude (4.8 vs. 7.0 microV; P less than 0.05) pointed to improvement of sensory pathways by mechanisms unrelated to cognition. Brain dysfunction in chronic hemodialysis patients may, beside other factors, in part be caused by severe anemia and can be improved by rHuEPO treatment.
为评估重组人促红细胞生成素（rHuEPO）对脑功能的影响，对15例慢性血液透析患者在使用rHuEPO前（血细胞比容22.7%）和使用后（血细胞比容30.6%），通过事件相关P300、刺激相关诱发电位和连线测验进行了研究。音调辨别范式诱发的P300峰潜伏期有所改善（之前为391毫秒，之后为366毫秒；Cz =头顶；P<0.01），证实对大脑认知加工有有益作用。P300波幅（13.6微伏对15.8微伏；P = 0.06）和连线测验也有改善趋势（55秒对43秒）。使用rHuEPO前，P300测量值受低血红蛋白水平影响（P<0.01），提示严重贫血可能导致尿毒症脑功能障碍。此外，刺激相关听觉脑干I-V峰间潜伏期缩短（之前为4.28毫秒，之后为4.17毫秒；P<0.05），体感N20/P25波幅增加（4.8微伏对7.0微伏；P<0.05），表明感觉通路通过与认知无关的机制得到改善。除其他因素外，慢性血液透析患者的脑功能障碍部分可能由严重贫血引起，rHuEPO治疗可改善这种情况。
