重组人红细胞生成素对血透患者血脂的影响

目的 :探讨重组人红细胞生成素 (rh -EPO)对血液透析 (HD)患者脂质代谢紊乱的改善作用及其相关机制。方法 :4 0例HD患者 ,1 0例采用常规HD治疗 ,30例加用常规剂量的rh -EPO ,观察两组血清总胆固醇 (CHOL)、总甘油三酯 (TG)、高密度脂蛋白 (HDL)、低密度脂蛋白 (LDL)、空腹血糖(Glu)、空腹血浆胰岛素 (Ins)及胰岛素敏感指数 (ISI)的变化。结果 :HD组较治疗前TG明显升高 (P <0 .0 5 ) ,HDL明显降低 (P <0 .0 5 ) ,rh -EPO组治疗后TG明显下降 (P <0 .0 5 ) ,HDL明显升高 (P <0 .0 5 ) ;rh -EPO组治疗后Ins明显降低 (P <0 .0 1 )、ISI显著升高 (P <0 .0 5 ) ,HD组则无变化。结论 :rh -EPO可能通过提高胰岛素敏感性、降低血清胰岛素而改善HD患者脂质代谢紊乱。

Effect of recombinant human erythropoietin on lipid metabolism in hemodialysis patients

Objective: To investigate the effect and related mechanism of rh-EPO on lipid metabolism in hemodialysis patients.Methods: 30 rh-EPO treated anemic patients on maintenance hemodialysis(rh-EPO group), 10 patients on maintenance hemodialysis(HD group), 10 healthy volunteers(control group) were involved in this study. Lipids, plasma glucose, insulin were measured. The reverse of fasting plasma glucose and insulin(Ins) product were used as an index of insulin resistance.Results: In rh-EPO group, serum triglyceride(TG) found was decreased(P<0.05), and high-density lipoprotein(HDL) increased(P<0.05); while the changes of TG and HDL were reversed in HD group(P<0.05). In rh-EPO group, Ins was decreased(P<0.01), and insulin sensitivity index(ISI) was significantly increased; while the change was not found in HD group. Conclusion: rh-EPO improved lipid metabolism in hemodialysis may be related to the increased ISI and decreased plasma insulin.