血管紧张素转换酶抑制剂或受体拮抗剂对促红细胞生成素治疗肾性贫血的影响

Effect of angiotensin converting enzyme inhibitior or angiotensin-Ⅱ receptor blocker on recombinant human erythropoietin in treating renal anemia patients

目的研究肾性贫血患者应用ACEI或ARB治疗高血压是否干扰rHuEPO治疗贫血的疗效。方法60例肾性贫血患者,其中非透析组30例,随机分入A组(厄贝沙坦)和B组(非洛地平);30例透析患者被随机分入C组(依那普利)和D组(硝苯地平缓释片)。四组均使用促红细胞生成素治疗肾性贫血,经过12周观察,分析这些降压药物对肾性贫血疗效的影响。结果使用ARB的A组或ACEI的C组患者血红蛋白、网织红细胞值、C-反应蛋白均低于B组和D组(P<0.01),而A组与C组的血浆清蛋白水平更高。结论ACEI或ARB可以干扰rHuEPO治疗肾性贫血的疗效,但其C-反应蛋白降低和血浆清蛋白的升高得益于患者炎症状态及营养状态的改善。

Objective Researching if the usage of ACEI or ARB on renal anemia patients for hypertension will interfere the therapeutic effect of rHuEPO for anemia. Methods The 60 examples of renal anemia patients, among 30 in non-dialysis group, randomly divided into group A （ Irbesartan ） and group B （ felodipine ） ; another 30 dialysis patients randomly divided into group C （ Enalapril ） and group D（ Extended Release Nifedipine Tablets）. All four groups use Erythropoietin to treat renal anemia and after 12 weeks observing,analyzing the effect of ose antihypertensive drugs on renal anemia. Results patients hemoglobin, reticulecyte and C-reactiye protein in group A with ARB and group C with ACEI are lower than group B and group D（ P 〈 0.01） ,but gronp A and C plasma-albumin level is higher. Conclusion ACEI and ARB can interfere the therapeutic effect of rHuEPO on renal anemia, but the decrease of C-reactive protein and increase of plasma-albumin conduce to patients＇ inflammation and nutritional state.