肾性贫血原因及相关机制的研究进展  

Research Progress in Causes and Related Mechanisms of Renal Anemia

作　　者：林小珍 周静[1] LIN Xiao-zhen;ZHOU Jing(Department of Nephrology,the First Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第一附属医院肾脏内科,南昌330006

出　　处：《南昌大学学报（医学版）》2022年第4期95-101,共7页Journal of Nanchang University：Medical Sciences

摘　　要：肾性贫血是慢性肾脏病(CKD)常见的并发症,不但加重肾脏病的进展,降低患者的生活质量,还是慢性肾脏病患者心血管并发症的独立危险因素。肾性贫血的发生是多因素造成的,与促红细胞生成素(EPO)分泌减少、铁代谢异常、炎症状态、毒素堆积、EPO抵抗、胃肠道慢性失血、红细胞寿命缩短、营养不良、药物使用、合并其他疾病、手术及透析失血和血液透析装置等有关。临床医生要注意观察CKD患者病情,及时处理相关异常指标。规范治疗后,未见明显好转时需警惕抗EPO抗体相关纯红细胞再生障碍性贫血及慢性肾衰竭合并自身免疫性溶血性贫血的可能。缺氧诱导因子新型药物、靶向抑制铁调素药物及肾间质纤维化抑制药物等研究,可为治疗肾性贫血提供新的思路。Renal anemia,a common complication of chronic kidney disease(CKD),not only aggravates the progression of kidney disease and reduces the quality of life of patients,but also is an independent risk factor for cardiovascular complications in patients with CKD.The occurrence of renal anemia is caused by multiple factors.It is associated with reduced erythropoietin(EPO)secretion,abnormal iron metabolism,inflammatory state,toxin accumulation,EPO resistance,chronic blood loss in gastrointestinal tract,shortened red blood cell life,malnutrition,drug use,other diseases,blood loss because of surgery and hemodialysis,hemodialysis devices,etc.Clinicians should pay attention to the condition of CKD patients and timely treat the abnormal indicators.The possibility of anti-EPO antibody-associated pure red cell aplastic anemia and chronic renal failure complicated by autoimmune hemolytic anemia should be warned if there is no obvious improvement after standard treatment.Studies on novel drugs for hypoxia-inducible factor and drugstargeting hepcidin and renal interstitial fibrosis can provide new ideas for the treatment of renal anemia.

关 键 词：肾性贫血 慢性肾脏病 促红细胞生成素 促红细胞生成素抵抗 核苷酸结合寡聚化结构域样受体蛋白3炎性小体 铁调素 丙烯腈 

分 类 号：R692.5[医药卫生—泌尿科学]