维持性血液透析患者甲状旁腺激素对重组人促红细胞生成素疗效的影响  

Clinical analysis of hemodialysis patients' parathyroid hormone on recombinant human erythropoietin

作　　者：王俊峰[1] 李宏辉[1] 李晓艳[1] 林强[1] 汪俊超[1] 钟小艳[1] 吴仁远[1] 陈科[1] 

机构地区：[1]成都军区机关医院肾病科,四川成都610011

出　　处：《西部医学》2011年第10期1927-1929,共3页Medical Journal of West China

摘　　要：目的探讨维持性血液透析患者甲状旁腺激素(iPTH)对重组人促红细胞生成素(r-EPO)疗效的影响。方法 92例维持性血液透析患者于透析日空腹采血测定血红蛋白(Hb)、红细胞比积(Hct)、血清铁蛋白(SFe)、C反应蛋白(CRP)、血清钙(Ca)、磷(P)、血浆白蛋白(Alb)、血清肌酐(Cr)和iPTH,记录重组人促红细胞生成素(r-HuEPO)用量,r-EPO用量/Hct比值(EPO/Hct)作为r-EPO疗效的指标。结果 92例维持性血液透析患者中71例(占77.2%)iPTH升高(iPTH增高组);21例(占22.8%)正常(iPTH正常组),iPTH增高组EPO/Hct比值、P、Ca×P和iPTH水平均高于iPTH正常组,Hct、Hb低于iPTH正常组;多因素Logistic回归分析表明,影响EPO/Hc比值的因素有iPTH、P、年龄和透析疗程(R2=0.374,P=0.041)。结论继发性甲状旁腺功能亢进是尿毒症患者的常见并发症之一,甲状旁腺激素升高是降低重组人促红细胞生成素疗效的主要因素之一。Objective To explore influence of hemodialysis patients＇ parathyroid hormone on the effect of erythropoietin.Methods The Hb,Hct,SFe,CRP,Ca,P,Alb,Cr and iPTH of 92 cases of hemodialysis patients were tested at dialysis day.The amount of the r-HuEPO was recorded,and the ratio of the amount of r-HuEPO and Hc was considered as indication of the effect of r-EPO.Results The iPTH of 71 hemodialysis patients in 92 cases（amounts to be 77.2%） increased.The iPTH of 21 hemodialysis patients in 92 cases（amounts to be 22.8%） lied within the normal scope.The value of ratio of EPO and Hct,P,Ca×P,and iPTH of the iPTH increased group were increased compared to the group with normal iPTH.Regression analysis of several factors indicated that,the value of EPO/Hc was influenced by those factors including iPTH,P,age,and the treatment of dialysis（R2=0.374,P=0.041）.Conclusion Secondary hyperparathyroidism is one of the common complications of uremic patients,and increment of parathyroid hormone is one of the key factors that degrade the effect of recombinant human erythropoietin.

关 键 词：肾性贫血 血液透析 甲状旁腺激素 重组人促红细胞生成素 

分 类 号：R459.5[医药卫生—治疗学]