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目的:观察促红素治疗不同程度微炎症状态维持性血液透析(MHD)患者肾性贫血的效果。方法:选择存在微炎症状态及贫血的MHD 226例,根据高敏C反应蛋白水平分为高水平组(10～15mg/L)62例、中水平组(3～9.9mg/L)95例和低水平组(0.05～2.9mg/L)69例,均给予促红素300U/(kg.w)治疗及低通量血液透析等常规治疗,疗程均为4个月。监测并比较3组血Hb、HCT水平及达到最佳治疗范围时间。结果:治疗后,3组血Hb、HCT水平均较治疗前显著或非常显著升高(P<0.05,P<0.01);但高水平组Hb、HCT水平显著或非常显著低于中低水平组,中水平组Hb水平显著低于低水平组(P<0.05,P<0.01)。低水平组、中水平组分别于治疗4周、14周时达最佳范围,高水平组治疗16周后Hb仍未达最佳范围。结论:促红素可有效改善不同微炎症状态MHD患者的肾性贫血,但微炎症因子水平越高则贫血治疗效果越差。
Objective: To observe the effect of erythropoietin on renal anemia in patients with maintenance microangiopathy (MHD) with different degrees of micro-inflammation. Methods: A total of 226 MHD patients with microinflammatory state and anemia were divided into two groups according to their high sensitivity C-reactive protein level: 62 cases in high level group (10-15 mg / L), 95 cases in middle level group (3-9.9 mg / L) (N = 69) received routine treatment of 300U / (kg.w) of erythropoietin and low-dose hemodialysis for 4 months in the level group (0.05-2.9mg / L). The blood levels of Hb and HCT and the optimal treatment time were monitored and compared. Results: After treatment, the levels of Hb and HCT in all three groups were significantly or very significantly higher than those before treatment (P <0.05, P <0.01); however, the levels of Hb and HCT in high level group were significantly or very significantly lower than those in the middle and low level group , While the level of Hb in middle level group was significantly lower than that in low level group (P <0.05, P <0.01). In the low and middle level groups, the optimal range was reached at the 4th week and the 14th week, respectively. After the 16th week of high level treatment, the optimal range of Hb was still not reached. CONCLUSION: Erythromycin can effectively improve renal anemia in MHD patients with different micro-inflammatory states. However, the higher the micro-inflammatory factor level, the worse the anemia treatment effect.