维持性血液透析患者重组人红细胞生成素治疗剂量的影响因素

目的分析影响维持性血液透析（MHD）患者重组人红细胞生成素（rHuEPO）治疗剂量的因素。方法选择72例血红蛋白（Hb）达标（≥100g／L）的MHD患者，分析每周rHuEPO治疗剂量与糖尿病、使用血管紧张素转化酶抑制剂（ACEI）和（或）血管紧张素受体拈抗剂（ARB）、微炎症、缺铁、联合血液透析滤过（HDF）治疗、透析充分、继发性甲状旁腺功能亢进（SHPT）、低蛋白血症等临床因素的相关性。结果有糖尿病组较无糖尿病组、使用ACEI和（或）ARB组较未用ACEI和（或）ARB组、有微炎症组较无微炎症组、缺铁组较不缺铁组每周rHuEPO治疗剂量均增加（P〈0．05）。而是否联合HDF治疗、透析是否充分、有无SHPT、有无低蛋白血症，每周rHuEPO治疗剂量均无差异（P〉0．05）。结论糖尿病、使用ACEI和（或）ARB、微炎症、缺铁影响MHD患者rHuEPO治疗剂量。

Related factors affecting the therapeutic dose of recombinant human erythropoietin in maintenance hemodialysis patients

Objective To investigate the related factors affecting the therapeutic dose of recombinant human erythropoietin （rHuEPO） in maintenance hemodialysis （MHD） patients. Methods Seventy-two MHD patients with hemoglobin （Hb） ≥ 100 g/L were enrolled. The correlation between different clinical factors and the therapeutic dose of rHuEPO was analyzed. Results The therapeutic dose of rHuEPO was higher in diabetes group, angiotensin converting enzyme inhibitors（ACEI）/angiotensin receptor blockers （ARB） group, mieroinflammatory group and the iron deficiency group than their comparatively groups （P〈0. 05）. Hemodiafihration（HDF）, dialysis adequacy, secondary hyperparathyroidism and hypoproteinemia did not affect the therapeutic dose of rHuEPO （P〈0. 05）. Conclusions Diabetes, ACEI/ARB,microinflammation and iron deficiency affect the therapeutic dose of rHuEPO in MHD patients.