红细胞生成素对慢性肾功能衰竭患者肾功能的影响

Influences of erythropoietin on the progression of chronic renal failure in predialysis patients

目的评价重组人红细胞生成素(rHuEPO)治疗对慢性肾功能衰竭(CRF)患者残余肾功能的影响。方法选取CRF患者75例,随机分为两组。对照组在积极治疗原发病的同时给予保护肾功能、加强营养、补充铁剂和叶酸等治疗。治疗组在对照组治疗措施基础上予以rHuEPO上臂皮下注射,起始剂量为3000U,2次/周,根据Hb调整剂量,Hb目标值在130g/L以内。比较两组治疗前后Hb、SCr及Ccr变化。结果治疗组随访12周即可观察到Hb明显升高,与对照组比较差异有统计学意义(P<0.01),SCr、Ccr无明显升高,与对照组比较差异均无统计学意义;随访24～48周,Hb有进一步升高趋势,48周时治疗组Hb110～120g/L30例(78.9%),Hb<110g/L5例(13.2%),>120g/L3例(7.9%),SCr和Ccr仍然保持稳定。两组随访48周均无维持性透析病例。结论rHuEPO治疗老年人透析前贫血对于提高其生活质量具有重要意义,对CRF患者残余肾功能没有明显的不利影响。

Objective To evaluate influences of recombinant human erythropoietin （rHuEPO） on the progression of chronic renal failure in predialysis patients. Methods The changes of hemoglobin （Hb）, serum creatine （SCr）, and creatine clerance （CCr） were observed in 38 patientes treated with rHuEPO, and 37 controls with routine treatment. Results A significant increment of Hb concentration was observed in treatment group 12 weeks later compared with control group （P〈0.01）. When the treatment group was treated by rHuEPO in 48 weeks,the hemoglobin comcentration was 110~120g/L in 30 patients （78.9%）,Hb〈110 g/L in 5 cases （13.1%）, Hb〉12 g/L in 3 cases （7.9%）. The changes of SCr levels and Ccr values were insignificant, and no maintenance dialysis cases in two groups 48 weeks later. Conclusions Our results suggest that correction of anaemia with rHuEPO has been shown to markedly improve the quality of life of old predialysis patients and did not result in deleterious effects on the residual renal function of CRF.