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促红细胞生成素治疗血液透析患者贫血:对运动能力的长期影响

Treatment of anaemia in haemodialysis patients with erythropoietin: long-term effects on exercise capacity.

作者信息

Bárány P, Freyschuss U, Pettersson E, Bergström J

机构信息

Department of Renal Medicine, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden.

出版信息

Clin Sci (Lond). 1993 Apr;84(4):441-7. doi: 10.1042/cs0840441.

DOI:10.1042/cs0840441
PMID:8482049
Abstract
  1. The effects of correcting anaemia on exercise capacity were evaluated in 21 haemodialysis patients (aged 39 +/- 12 years) before starting treatment with recombinant human erythropoietin (Hb concentration, 73 +/- 10 g/l; total Hb, 59 +/- 12% of expected), after correction of the anaemia to a Hb concentration of 108 +/- 7 g/l and a total Hb 82 +/- 10% of expected, and in 13 of the patients after 12 months on maintenance recombinant human erythropoietin treatment (Hb concentration 104 +/- 14 g/l, total Hb 79 +/- 17% of expected). Fifteen healthy subjects (aged 41 +/- 9 years), who took no regular exercise, constituted the control group. Maximal exercise capacity was determined on a bicycle ergometer. Oxygen uptake, respiratory quotient, blood lactate concentration, heart rate and blood pressure were measured at rest and at maximal workload. 2. After 6 +/- 3 months on recombinant human erythropoietin, maximal exercise capacity increased from 108 +/- 27 W to 130 +/- 36W (P < 0.001) and the maximal oxygen uptake increased from 1.24 +/- 0.39 litres/min to 1.50 +/- 0.45 litres/min (P < 0.001). No significant changes in respiratory quotient (1.16 +/- 0.13 versus 1.18 +/- 0.13) and blood lactate concentration (4.0 +/- 1.8 versus 3.6 +/- 1.1 mmol/l) at maximal workload were observed, but the blood lactate concentration in the patients was significantly lower than that in the control subjects (6.7 +/- 2.3 mmol/l, P < 0.01). After the correction of anaemia, the aerobic power was still 38% lower in the patients than in the control subjects and 17% lower than the reference values.(ABSTRACT TRUNCATED AT 250 WORDS)
摘要
  1. 在21例血液透析患者(年龄39±12岁)开始接受重组人促红细胞生成素治疗前(血红蛋白浓度73±10g/L;总血红蛋白为预期值的59±12%)、贫血纠正至血红蛋白浓度108±7g/L且总血红蛋白为预期值的82±10%后,以及13例患者接受维持性重组人促红细胞生成素治疗12个月后(血红蛋白浓度104±14g/L,总血红蛋白为预期值的79±17%),评估纠正贫血对运动能力的影响。15名不经常运动的健康受试者(年龄41±9岁)组成对照组。在自行车测力计上测定最大运动能力。在静息状态和最大负荷时测量摄氧量、呼吸商、血乳酸浓度、心率和血压。2. 接受重组人促红细胞生成素治疗6±3个月后,最大运动能力从108±27W增加至130±36W(P<0.001),最大摄氧量从1.24±0.39升/分钟增加至1.50±0.45升/分钟(P<0.001)。在最大负荷时,呼吸商(1.16±0.13对1.18±0.13)和血乳酸浓度(4.0±1.8对3.6±1.1mmol/L)无显著变化,但患者的血乳酸浓度显著低于对照组受试者(6.7±2.3mmol/L,P<0.01)。贫血纠正后,患者的有氧能力仍比对照组受试者低38%,比参考值低17%。(摘要截选至250词)

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