纠正维持性血液透析患者贫血对逆转左心室肥厚的作用

 目的 观察应用重组人促红细胞生成素(recombinant human erythropoietin,rHuEPO)纠正维持性血液透析(maintenance hemodialysis,MHD)患者贫血对逆转左心室肥厚(left ventricular hypertrophy,LVH)的作用.方法 选择我院血透中心40例MHD患者随机分为两组:治疗组20例予rHuEPO皮下注射治疗,起始量每周80～120 U/kg;当血红蛋白(Hb)110～120 g/L、血细胞比容(Hct)033~036时rHuEPO减为维持量.对照组20例不使用rHuEPO治疗.两组在治疗过程中均积极控制血压在正常或接近正常水平.观察并比较两组Hb、Hct、左心室重量指数(LVMI)、收缩压(SBP)、舒张压(DBP)情况.结果 治疗前后两组SBP、DBP差异无统计学意义(P>0.05),治疗后治疗组较对照组Hb、Hct明显升高(P<0.01),LVMI降低(P<0.01).结论 纠正MHD患者贫血可部分逆转左心室肥厚.

Effects of recombinant human erythropoietin on left ventricular hypertrophy in anemic patients on maintenance hemodialysis

Objective To investigate the efficacy of recombinant human erythropoietin(rHuEPO) on reversing left ventricular hypertrophy(LVH) by improving anemia in patients on maintenance hemodialysis(MHD).Methods Forty patients on MHD were randomly divided into two groups;treatment group(group A) and control group B.In Group A(=20),the patients were given rHuEPO 80 - 120 u / kg / w through hypodermic injection to begin with.When hemoglobin(Hb) reached 110 - 120 g/L and the hemato-crit (Hct) was 0.33～0.36,the dose of rHuEPO was decreased to the maintenance dose.In Group B(=20),the patients did not receive rHuEPO therapy.The blood pressure of all the patients in the two groups were normal or near normal during the treatment.Hb, Hct,left ventricular mass index(LVMI),systolic blood pressure(SBP),and diastolic blood pressure(DBP) were compared between the two groups.Results There were no significant changes in SBP or DBP in the two groups after treatment(P>0.05).Hb and Hct increased significantly in Group A after treatment(P<0.01).LVMI in Group A declined after treatment(P<0.01).Conclusions rHuEPO therapy reverses LVH by correcting anemia in patients on MHD.