血液透析患者高C-反应蛋白对促红细胞生成素敏感性的影响

High C-reactive protein in hemodialysis patients reduce the sensitiveness of erythropoietin

目的研究高血清C反应蛋白(CRP)对血液透析患者促红细胞生成素(EPO)治疗效果的影响。寻找血液透析患者EPO抵抗原因。方法以30例血红蛋白近10 g.d l-1、血清Fe、血清白蛋白、K t/Vurea、PTH无明显差异的血液透析患者为对象,根据CRP水平分两组,第一组:血清CRP≤10 mg.L-1,第二组:血清CRP≥10 mg.L-1。比较两组EPO剂量与血清C反应蛋白水平的关系。结果血清CRP≥10 mg.L-180%的患者每周EPO的剂量明显高于血清CRP≤10 mg.L-1的患者。结论血清CRP水平影响EPO的疗效,对判断EPO治疗效果有一定临床意义。高CRP是导致血液透析患者EPO抵抗原因之一。

Aim To study the effect of high C-reactive protein （CRP） on dose of erythropoietin （EPO） in hemodialysis patients. Methods The 30 cases of hemodialysis patients whose hemoglobin were approximate 10 g ·dl^-1 were chosen. To investigate the relationship between serum CRP and the close of EPO required to maintain hemoglobin levels at approximate 10 g ·dl^-1 in hemodialysis. According to the level of serum CRP, the patients were divided into two groups ,The first with CRP lower than 10 mg·L^-1. The second with CRP higher than 10 mg ·L^-1. Serumferrum （Fe） , albumin （Alb） , hemoglobin （Hb） , Kt/Vurea, PTH were measured respectively in the two groups. Results The weekly EPO dose in patients with CRP higher than 10 mg ·L^-1 was,on average,80% higher than that in patients with CRP low than 10 mg ·L^-1. Serum Fe, serum Alb, Hb, Kt/Vurea, PTH are not different. Conclusion High CRP level is a strong predictor of resistance to EPO in maintaining hemodialysis patients.