接受慢性血液透析患者中血管紧张素转换酶抑制剂与促红细胞生成素α的潜在相互作用。
Potential angiotensin-converting enzyme inhibitor-epoetin alfa interaction in patients receiving chronic hemodialysis.
作者信息
Schwenk M H, Jumani A Q, Rosenberg C R, Kulogowski J E, Charytan C, Spinowitz B S
机构信息
Division of Nephrology and Hypertension, The New York Hospital Medical Center of Queens, Flushing 11355, USA.
出版信息
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。
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