基因重组促红细胞生成素对血透患者一氧化氮及内皮素与血管紧张素Ⅱ的影响  

Effect of Recombinant Human Erythropoietin on Nitric Oxide,Endothelin-1 and Angiotension-Ⅱ in Chronic Hemodialysis Patients

作　　者：邓利荣[1] 王彩丽[1] 杨玉华[1] 张艳辉[1] 

机构地区：[1]包头医学院第一附属医院肾内科,包头014010

出　　处：《中国中西医结合肾病杂志》2006年第5期275-278,共4页Chinese Journal of Integrated Traditional and Western Nephrology

摘　　要：目的:探讨基因重组促红细胞生成素(rHuEpo)对维持性血透患者血管活性物质一氧化氮(NO)、内皮素-1(ET-1)、血管紧张素Ⅱ(AngⅡ)的影响。方法:将长期规律性血透尿毒症患者80例分为血液透析应用rHuEpo者(HDepo组,n=43例),血液透析不应用rHuEpo者(HD组,n=37),根据血压情况两组再分为HDepo高血压亚组(HDepo-1组,n=23)、HDepo血压正常亚组(HDepo-2组,n=20)和HD高血压亚组(HD-1组,n=19)、HD血压正常亚组(HD-2组,n=18)。另选尿毒症未透析患者20例(NHD组)、健康对照组20例(CON组,n=20)。HDepo组患者均接受rHuEpo治疗3个月以上,用比色法测定血NO水平,用放射免疫法测定血ET-1、AngⅡ水平。结果:(1)尿毒症透析患者血清NO、ET-1、AngⅡ浓度较正常对照组高(P<0.001)。透析治疗的尿毒症患者与尿毒症未透析者比较,血清NO水平较未透析者低,血清ET-1、AngⅡ水平较未透析者高(P<0.05)。(2)HDepo组经rHuEpo治疗3月后,血NO水平降低,血清ET-1、AngⅡ水平增高,与用药前及对照组比较(P<0.05)。(3)用rHuEpo治疗后,HDepo组收缩压、舒张压、平均动脉压均较HD组高(P<0.001),血压增高与血NO浓度的降低,血清ET-1、AngⅡ浓度的增高有相关性。结论:rHuEpo可使尿毒症透析患者血清NO水平降低、血ET-1、AngⅡ水平增高,rHuEpo所致高血压与血NO浓度的降低,血清ET-1、AngⅡ浓度的增高有相关性。Objective： To investigate the effect of recombinant Human erythrolmietin （rhuElm） on Nitric Oxide （NO）, Endothelin- 1 （ET- 1 ） and Angiotension- Ⅱ （Ang Ⅱ ） in chronic hemodialysis patients. Methods：Eighty patients on chronic hemodialysis were enrolled in this randomized, controlled study. Forty- three received rhuElm（ HDepo n = 43） and thirty-seven did not（HD n = 37）. According to the blood pressure, each group was sub- divided into two groups, HDepo with hypertention （HDepo- 1 group n-23）, HDepo with normal blood pressure （HDepo-2 group n -20）, HD with hypertention （HD- 1 group n = 19）, HD with normal blood pressure （HD- 2 group n = 18）. Twenty uremia patients who did not receive hemodialysis therapy and twenty normal adults were chosen as control group （CON group）. The NO level was measured by colorimetry. The ET- 1 level and the Ang Ⅱ level were measured by radioimmunoassay （RIA）. Results： The NO level, ET- 1 level, Ang Ⅱ level in uremia patients receiving HD therapy were higher than those in normal control group （P〈0. 001 ）. The NO level in serum of hemodialysis patients was higher than that in patients did not receive hemodialysis therapy. The ET- 1 level and Ang Ⅱ level were higher than those in patients did not receive hemodialysis therapy（ P〈 0.05）.After three months＇ therapy, the NO consistency in serum in HD group declined after the rHuepo therapy, it was lower than that of normal control group. While the ET- 1 consistency and AngⅡ concentration raised（P〈0.05）. After the therapy, diastolic pressure, systolic pressure, mean arterial pressure of HDepo group were all higher than those of HD group （ P〈0. 001 ）. The increase in blood pressure correlated with the decline of the NO concentration as well as increasw in ET- 1 and Ang Ⅱ concentration. Conclusion： Erythrolmietin can reduce serum NO concentration in chronic hemodialysis patients. It also can raise ET - 1 and Ang Ⅱ concentration. Hypertention caused by

关 键 词：促红细胞生成素 血液透析 一氧化氮 内皮素 血管紧张素 

分 类 号：R692.5[医药卫生—泌尿科学]