Hu J P, Cheng X, Xu X F, Yu G J, Luo F, Zhang G S, Yang N, Shen P, Yan X Y
Nephrology Division of Zhengzhou TCM Hospital, Zhengzhou, Henan, China.
Nephrology Division of the Affiliated Hospital of Henan Province Chinese Medicine Research Institute, China.
J Biol Regul Homeost Agents. 2016 Apr-Jun;30(2):535-40.
To explore the reactivity of patients with renal anemia (MHD) to erythropoietin (EPO) in maintenance hemodialysis (HD), 31 patients were enrolled in this study. According to the level of serum ferritin (SF), they were divided into two groups; one group received treatment using recombinant human erythropoietin (rHuEPO) and the other group was given iron sucrose. Taking terminal EPO dosage, terminal erythropoietin resistance index (ERI) and rate of change of ERI (ΔERII) as target indexes, the influence of SF level on dosage of EPO was evaluated after usage conditions of relevant substances in a 3-month period. The results revealed that differences of dialysis age, albumin (ALB), blood calcium, initial and terminal SF, variable quantity of hemoglobin (Hb), terminal EPO and ERI between two groups had statistical significance. Furthermore, SF level and terminal EPO (r = -0.37, P < 0. 05) as well as SF level and terminal ERI (r = - 0.39, P <0.05) were negatively correlated. Difference of terminal ERI between the two groups had statistical significance. It can therefore be summarized that supplementing an iron agent intravenously to maintain SF level between 500 ng/ml and 1200 ng/ml may improve reactivity of patients with MHD to EPO. In addition, rHuEPO therapy in treating anemia of patients with MHD has the same effect with intravenous drug delivery, less side effects and is easy to administer.
为探讨维持性血液透析(HD)患者肾性贫血(MHD)对促红细胞生成素(EPO)的反应性,本研究纳入31例患者。根据血清铁蛋白(SF)水平将其分为两组;一组接受重组人促红细胞生成素(rHuEPO)治疗,另一组给予蔗糖铁。以终末EPO剂量、终末促红细胞生成素抵抗指数(ERI)及ERI变化率(ΔERII)为观察指标,观察3个月内相关物质使用情况后评估SF水平对EPO剂量的影响。结果显示,两组患者的透析龄、白蛋白(ALB)、血钙、初始及终末SF、血红蛋白(Hb)变化量、终末EPO及ERI差异有统计学意义。此外,SF水平与终末EPO(r = -0.37,P < 0.05)以及SF水平与终末ERI(r = -0.39,P < 0.05)呈负相关。两组终末ERI差异有统计学意义。由此可以总结,静脉补充铁剂使SF水平维持在500 ng/ml至1200 ng/ml之间可能会提高MHD患者对EPO的反应性。此外,rHuEPO治疗MHD患者贫血的效果与静脉给药相同,副作用少且易于给药。