促红细胞生成素导致高血压的临床研究

Hypertension Caused by Recombinant Human Erythropoietin

通过对４０例不同年龄、不同病因的尿毒症维持性血透患者，应用不同剂量的促红素治疗、观察血色素、血粘度、血浆肾素、血管紧张素、心排出量、外周血管阻力以及血压变化等临床指标，发现促红素对肾性贫血的疗效为９０％，但高血压的发生也达３７．５％。高血压的发生与促红素的剂量、患者的年龄；以往有无高血压等有关。高血压发生的时间大部分随着血色素的增加而增高，但少数与此无关，血粘度和心排出量的增加，血浆肾素和血管紧张素的变化在这类高血压的发生中不占主要地位。高血压发生的主要机理是外周血管阻力的增加。

In order to understand the morbidity,the mechanism and relevant factors of hypertension in recombinat human erythropoietin (rHuEPO) treating renal anaemia, alterations in hemoglobin, blood viscosity,plasma concentration of renin and angiotensin,and blood pressure, cardiac output and peripheral vascular resistance were evaluated in 40 patients with uremia who had undergone maintaining hemodialysis.All patients were treated with erythropoietin for renal anemia. After treatment, renal anemia was inproved in 90% of the patients, but 37.5%of those developed hypertension. The occurrence of hypertension correlated closely with the dosage of erythropoietin and the age of the patients, and was related to previotis history of hypertension. In the majority of the patients, hypertension occurred when hemoglobin level was high. However, an increase in blood viscosity and cardiac output and changes in plasma concentration of renin and angiotensin did not play an important role in the pathogenesis of hypertension. The mechanism of hypertension may possibly be due to an augmentation of peripheral vascular resistance.