论文部分内容阅读
目的:通过重组人红细胞生成素(rHuEPO)纠正贫血,阻断心衰、肾衰和贫血形成的恶性循环,提高血液透析患者生存质量及存活率。方法:血红蛋白(Hgb)≤85g·L-1、红细胞压积(Hct)≤25%的患者,接受rHuEPO治疗,起始剂量每周100U·kg-1,分2次皮下注射,疗程为12周,预期目标值为Hgb100～110g·L-1、Hct30%～33%;有76例患者完成12周治疗后未被剔除,将Hgb≥100g·L-1、Hct≥30%的患者30例列入观察组,Hgb<100g·L-1、Hct<30%的患者46例列入对照组。结果:显效27例、有效39例,总有效率86.84%(66/76);2组患者治疗后Hgb均显著升高(P<0.01),但观察组患者Hgb升高较对照组更显著(P<0.01)。经治疗改善贫血后,可使所有患者重度心功能不全(Ⅲ级/Ⅳ级)构成比及心率显著下降(P<0.01,P<0.05),EF、SV显著增高(P<0.01);并使观察组患者LVDd明显缩小(P<0.05)。治疗12周后,观察组与对照组的EF、SV、LVDd改变差异有显著性(P<0.05)。结论:及早应用rHuEPO纠正贫血达目标值能使血液透析患者的心脏功能和结构好转。
OBJECTIVE: To correct the anemia by recombinant human erythropoietin (rHuEPO), block the vicious circle of heart failure, renal failure and anemia and improve the quality of life and survival rate of hemodialysis patients. Methods: Patients with Hgb ≤85g · L-1 and hematocrit ≤25% were treated with rHuEPO at a dose of 100U · kg-1 per week for 2 weeks. The course of treatment was 12 weeks , The expected target value was Hgb100 ~ 110g · L-1, Hct30% ~ 33%; 76 patients were not rejected after 12 weeks of treatment, 30 patients with Hgb≥100g · L-1, Hct≥30% Into the observation group, Hgb <100g · L-1, Hct <30% of 46 patients were included in the control group. Results: 27 cases were markedly effective and 39 cases were effective. The total effective rate was 86.84% (66/76). Hgb in both groups were significantly increased (P <0.01), but the Hgb in observation group was more significant than that in control group P <0.01). After treatment to improve anemia, all the patients with severe cardiac insufficiency (Ⅲ / Ⅳ grade) ratio and heart rate decreased significantly (P <0.01, P <0.05), EF, SV significantly increased (P <0.01) LVDd in observation group was significantly reduced (P <0.05). After 12 weeks of treatment, there were significant differences in the changes of EF, SV and LVDd between the observation group and the control group (P <0.05). CONCLUSIONS: The early application of rHuEPO to correct target anemia can improve heart function and structure in hemodialysis patients.