慢性炎症与血透患者促红细胞生成素低反应性关系研究

Relationship between chronic inflammation and hyporesponsiveness to erythropoietin in maintence hemodialysis patients

目的观察血液透析患者体内慢性炎症对重组人红细胞生成素(rHuEPO)反应性的影响。方法将40例维持性血液透析(MHD)患者按照rHuEPO反应性的不同分为两组:rHuEPO反应良好组22例和rHuEPO反应低下组18例,另设一健康对照组20例。透析前检测血清急性期反应蛋白hs-CRP和炎症因子IL-6、TNF-α的水平,并比较分析rHuEPO反应良好组和反应低下组之间的差异。结果尿毒症MHD患者体内平均TNF-α、IL-6、hs-CRP水平显著高于正常对照组。rHuEPO反应低下组的TNF-α、IL-6、CRP水平显著高于反应良好组。结论尿毒症MHD患者体内存在慢性炎症状态,慢性炎症是导致rHuEPO低反应性的重要原因之一。

Objective： To invesgate the effects of chronic inflammation on the hyporesponsiveness to rHuEPO.Methods： The maintence hemodialysis patients（MHD） were divided into two groups according to the responsiveness to rHuEPO： 22 cases with good response and 18 case with poor response.The levels of serum high-sensitive CRP,IL-6,TNF-α,serum ferritin,transferring saturation,blood urea nitrogen,creatinine,iPTH and so on were detected using routine methods in our hospital chemistry laboratory.Results： The concentrations of hs-CRP,IL-6,TNF-α in serum of MHD patients were higher than those in the normal control.The concentrations of them in serum of poor response to rHuEPO were much higher than those of good response to rHuEPO.Conclusion： Chronic inflammation state is common in MHD.Cytokines in chronic inflammation play a central role in pathogenesis of hyporesponsiveness to rHuEPO.