rHuEPO对维持性血液透析患者心功能的影响

Effects of rHuEPO on cardiac structure and function in maintenance hemodialysis patients

目的观察组重组人红细胞生成素(rHuEPO)对维持性血液透析患者心功能的影响。方法将36例患者按2∶1比例分入rHuEPO治疗组和对照组。治疗前及治疗后观察血色素(Hb)以及心脏彩超测定左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD),室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左房内径(LAD)。左室射血分数(LVEF),左心室心肌质量(LVM),并计算左室心肌质量指数(LVMI),在二尖瓣区测量舒张早期和舒张晚期最大血流速度并计算两者的比值(E/A)等指标,并进行比较。结果应用rHuEPO治疗6个月后,治疗组Hb、LVEDD、LAD、LVEF、LVM以及E/A均有显著性改善(均P<0.05);而对照组上述指标无明显变化。结论应用rHuEPO治疗维持性血液透析患者,不仅能改善肾性贫血,而且能明显改善心脏功能。

AIM To investigate the changes of the cardiac function and structure in maintenance hemo- dialysis （MHD） patients after treatment with rHuEPO. METHODS Thirty-six patients were randomly divided into two groups by the ratio 2 ： 1, with 24 patients treated with rHuEPO in therapy group and 12 patients in control group. The echocardiographic parameters （LVEDD, LVESD, IVST, LVPWT, LAD, LVEF, LVM, LVMI and E/A） and Hb were compared before and after treatment with rHuEPO. RESULTS After six months, the patients in therapy group were improved in LVEDD, LAD, LVEF, LVM, E/A and Hb, while the patients in control group kept a steady hemoglobin level and echocardiographic parameters. CONCLUSION Most of the hemodialysis patients have cardiac diastolic dysfunction and left ventricular hypertrophy. After treatment with rHuEPO for 6 moths, there are changes not only in the hemoglobin level but also in the cardiac function, structure.