Linde T, Sandhagen B, Bratteby L E, de Verdier C H, Danielson B G, Wikström B
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Nephrol Dial Transplant. 1993;8(6):524-9. doi: 10.1093/ndt/8.6.524.
In addition to haemoglobin concentration, haemoglobin oxygen affinity plays a major role in the oxygen releasing capacity of the blood. In this study we have measured oxygen affinity as P50 and calculated the oxygen releasing capacity of blood from 10 haemodialysis patients treated with erythropoietin (rHuEpo). The patients were examined with different assays before start of treatment, after 11 weeks, and after 27 weeks. During the first phase of treatment the oxygen releasing capacity improved because of an increase in the haemoglobin concentration and P50. During the second phase there was a further significant increase in haemoglobin concentration, but due to a decrease in the P50 value the oxygen releasing capacity remained unchanged. Despite an unchanged oxygen releasing capacity and total blood volume, the antihypertensive treatment had to be increased during that phase of treatment. An increase in whole-blood viscosity may explain the increased need of antihypertensive drugs. The increase in P50 during the first phase of rHuEpo treatment can probably be explained by decreased mean age of the erythrocyte population and implies that the beneficial effect is greater than could be concluded from the increase in haemoglobin concentration.
除血红蛋白浓度外，血红蛋白对氧的亲和力在血液的氧释放能力中起主要作用。在本研究中，我们测定了作为P50的氧亲和力，并计算了10例接受促红细胞生成素（rHuEpo）治疗的血液透析患者的血液氧释放能力。在治疗开始前、11周后和27周后，用不同的检测方法对患者进行检查。在治疗的第一阶段，由于血红蛋白浓度和P50增加，氧释放能力提高。在第二阶段，血红蛋白浓度进一步显著增加，但由于P50值降低，氧释放能力保持不变。尽管氧释放能力和全血容量不变，但在该治疗阶段仍需增加抗高血压治疗。全血粘度增加可能解释了对抗高血压药物需求的增加。rHuEpo治疗第一阶段P50的增加可能是由于红细胞群体平均年龄降低所致，这意味着其有益作用大于仅从血红蛋白浓度增加得出的结论。
