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目的 :观察血液透析 (HD)及腹膜透析 (PD)尿毒症患者的红细胞生成素 (EPO)药代动力学变化及其对疗效的影响。方法 :采用酶联免疫吸附法 (ELISA)测定血清EPO ,对透析患者用EPO前后不同时间内血清及PD透出液中EPO含量进行检测。结果 :尿毒症患者血清EPO基础水平同海南地区健康人相似 (P >0 .0 5 ) ,皮下注射EPO后 2 4h血清EPO浓度最高 ,72h后恢复至用药前水平 ;不同时期PD透出液对EPO清除极少。轻度与中、重度贫血患者血清EPO浓度无显著性差异 (P均 >0 .0 5 )。结论 :尿毒症患者贫血的主要原因是EPO相对不足。不同透析方式对EPO的血清浓度无影响。PD对EPO的清除相对恒定 ,不影响用药后血清EPO峰值浓度。HD和PD患者出现对EPO治疗反应低下或抵抗时应从其他方面寻找原因。
Objective: To observe the changes of erythropoietin (EPO) pharmacokinetics in patients with hemodialysis (HD) and peritoneal dialysis (PD) uremia and their effects on the curative effect. Methods: Serum EPO was determined by enzyme-linked immunosorbent assay (ELISA), and the levels of EPO in serum and PD effluent of dialysis patients at different time before and after EPO were detected. Results: The serum EPO level in serum of uremic patients was similar to that of healthy people in Hainan (P> 0.05). The EPO concentration of serum was the highest at 24 hours after subcutaneous injection of EPO, and returned to the level of pre-medication after 72 hours. EPO clear very little. There was no significant difference in serum EPO concentration between mild and moderate to severe anemia (all P> 0.05). Conclusion: The main cause of anemia in uremic patients is the relative lack of EPO. Different dialysis methods have no effect on the serum concentration of EPO. The clearance of EPO by PD is relatively constant and does not affect the peak serum EPO concentration after treatment. Patients with HD and PD should look for causes in other areas if their response to EPO is low or resistant.