促红细胞生成素联合辛伐他汀对血液透析患者微炎症及贫血的影响

Effect of Erythropoietin and Simvastatin on Micro-inflammation State and Anemia of Hemodialysis Patients

目的通过观察促红细胞生成素(EPO)联合辛伐他汀及单独使用促红细胞生成素对维持性血液透析患者相关炎症和贫血指标的影响,了解其对维持性血液透析患者微炎症状态和贫血的作用,探讨促红细胞生成素联合他汀类药物在透析患者中应用。方法16例健康体检者作为正常对照组(A组);42例稳定维持血液透析患者,随机分成两组,EPO治疗组(B组)20例及辛伐他汀+EPO联合治疗组(C组)22例。实验期间B组只使用重组人促红细胞生成素(rhEPO);C组患者每天服用辛伐他汀,与rhEPO时间为2个月,分别在实验开始、结束时检测患者血C反应蛋白(CRP)、血红蛋白(HB)及血脂浓度。结果与A组相比,B、C两组C反应蛋白水平无明显著升高,HB和血细胞比容(HCT)水平显著降低;与治疗前相比,治疗后B组C反应蛋白水平显改变,HB和HCT有明显升高;与治疗前相比,治疗后C组HB和HCT明显升高、CRP明显降低,差异均有显著性(P<0.05),总胆固醇浓度改变差异无显著性(P>0.05),而甘油三酯较治疗前有所降低,差异有显著性(P<0.05);治疗后C组HB和HCT明显高于B组,差异有显著性(P<0.05)。结论促红细胞生成素联合辛伐他汀改善维持性血液透析患者贫血症状态优于单独使用促红细胞生成素,这种作用可能是通过改善患者微炎症状态实现的。

Objective To investigate the effects of erythropoietin and simvastatin combination on micro - inflammation state and anemia of maintenance hemodialysis （MHD） patients and solely of erythropoietin on it, comprehension and investigatethe effect of it on chronic micro - inflammation state and anemia of maintenance hemodialysis patients. Methods Sixteen healthy volunteers were assigned as control group （A） and 42 MHD patients were randomly assigned intoexperiment group B and C. Patients in the group B were treated with 10 000 U rhEPO hypodermic injection per week and in group C were taken 20 mg simvastatin orally per night with 10 000 U rhEPO hypodermic per week for 2 months. Before and after the experiment, C -reactive protein（ CRP）, Hb and blood lipids were tested. Results Compared with group A that group B and C CRP arised and Hb and hematocrit（HCT） declined significantly. After the treatment, the Hb and HCT were significantly higher in group C than in group B （ P 〈 0.05 ）. Conclusion Combination of erythropoietin and simvastatin can improve symptoms of anemia and micro - inflammation state of maintenance hemodialysis patients, which is superior to solely of erythropoietin.