血液透析及腹膜透析对尿毒症患者红细胞生成素的药代动力学影响

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＞ ０．０５）；皮下注射ＥＰＯ 后２４小时血清ＥＰＯ 浓度最高，７２ 小时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＞ ０．０５）。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。

Influences of hemodialysis and peritoneal dialysis on phamacokinetics of recombinant human erythropoietin

Objective:To observe the influences of hemodialysis (HD) and peritoneal dialysis (PD) on phamacokinetics of recombinant human erythropoietin(rHuEPO)and curative effects in patients with uremia.Methods:By means of ELISA the serum levels of EPO in patients who were on HD or PD before and after using rHuEPO and the EPO concentrations of serum and drawn dialysate at different times were detected.Results:The basic levels of EPO in patients with uremia were similar to those in healthy subjects of Hainan area ( P >0 05).The EPO concentrations within 24 hours after using rHuEPO injected subcutaneously were highest and 72 hours latter recovered to the same levels as before using rHuEPO.In drawn dialysate at different times few of EPO were eliminated.In patients with mild moderate,and severe anemia the concentrations of serum EPO had not significant differences (all P >0 05).Conclusions:The main cause of anemia in patients with uremia is relatively inadequate and the different dialysis pattern do not have any influence on serum concentrations of EPO.The PD is relative constancy for EPO to be eliminated and does not influence the peak concentrations of serum EPO.The reasons for patients who are on HD or PD to appear the diminished response or resistance to EPO therapy should be searched from other aspects.