Schwenk M H, Jumani A Q, Rosenberg C R, Kulogowski J E, Charytan C, Spinowitz B S
Division of Nephrology and Hypertension, The New York Hospital Medical Center of Queens, Flushing 11355, USA.
Pharmacotherapy. 1998 May-Jun;18(3):627-30.
We compared epoetin alfa (EPO) dose requirements and hematocrit response in 17 patients receiving chronic hemodialysis at baseline and after 3 and 12 months of therapy with angiotensin-converting enzyme (ACE) inhibitors (12 enalapril, 5 captopril). No acute processes were present (infection, hemorrhage, inflammation) at time of starting ACE inhibitor therapy. Mean (+/- SD) intravenous EPO dosages at zero, 3, and 12 months were 6012 +/- 2575, 5800 +/- 2026, and 5660 +/- 2285 U 3 times/week (p=0.56), and mean differences were -212 U for 0-3 months (95% CI -1310 to 886) and -713 U for 0-12 months (95% CI -2142 to 716). Mean +/- SD hematocrits were 30.5 +/- 3.9%, 31.6 +/- 3.2%, and 34.2 +/- 3.1% (p=0.01, zero vs 12 mo), and mean differences were 1.7% for 0-3 months (95% CI -1.41 to 4.81) and 3.85% for zero-12 months (95% CI 0.71-7). Our results indicate that ACE inhibitors do not increase EPO dose requirements or reduce hematocrits in these patients.
我们比较了17例接受慢性血液透析患者在基线时以及使用血管紧张素转换酶（ACE）抑制剂（12例依那普利，5例卡托普利）治疗3个月和12个月后的促红细胞生成素α（EPO）剂量需求和血细胞比容反应。开始使用ACE抑制剂治疗时不存在急性病程（感染、出血、炎症）。零个月、3个月和12个月时的平均（±标准差）静脉注射EPO剂量分别为6012±2575、5800±2026和5660±2285单位，每周3次（p = 0.56），0至3个月的平均差异为 -212单位（95%可信区间 -1310至886），0至12个月的平均差异为 -713单位（95%可信区间 -2142至716）。平均（±标准差）血细胞比容分别为30.5±3.9%、31.6±3.2%和34.2±3.1%（p = 0.01，零个月与12个月相比），0至3个月的平均差异为1.7%（95%可信区间 -1.41至4.81），零至12个月的平均差异为3.85%（95%可信区间0.71至7）。我们的结果表明，ACE抑制剂不会增加这些患者的EPO剂量需求或降低血细胞比容。
