促红细胞生成素对血液透析患者血浆脂联素水平及左心室肥厚的影响

The Effects of Erythropoietin on Plasma Adiponectin Levels and Left Ventricular Hypertrophy in Hemodialysis Patients

目的:促红细胞生成素(EPO)在维持性血液透析患者中具有保护心血管的作用,本文旨在探讨EPO在血液透析病人中对脂联素(ADPN)水平及左心室肥厚的影响。方法:46名维持性血液透析患者用EPO治疗8周,分别在治疗前,治疗第2、4、8周后测定血红蛋白(Hb),红细胞压积(Hct),血浆白蛋白(ALB),体重指数(BMI),C反应蛋白(CRP),血清铁蛋白(SF),血清铁饱和度(TAST),ELISA测定ADPN水平;彩色多普勒超声测定左心室心肌重量(LVM)及计算左心室心肌重量指数(LVMI)。结果:血液透析患者血清ADPN水平高于正常人;用EPO治疗2周后即出现ADPN水平升高,第4周后ADPN水平进一步升高,第8周与第4周比较无明显变化;应用EPO可降低CRP、SF水平;ADPN是LVMI的重要影响因子,EPO可改善左心室肥厚与功能。结论:EPO可提高血液透析患者ADPN水平,降低CRP、SF水平,减轻左心室肥厚。

Objective：Erythropoietin（EPO） has protective cardiovascular effect in maintenance hemodialysis patients.This study was designed to explore the effects of the EPO on adiponectin levels and left ventricular hypertrophy in hemodialysis patients.Methods：46 hemodialysis patients were randomly devided into group with EPO treatment for 8 weeks,respectively,were evaluated for hemoglobin（Hb）,hematocrit（Hct）,plasma albumin（ALB）,weight index（BMI）,C-reactive protein（CRP）,serum ferritin（SF）,serum iron saturation（TAST）,the plasma adiponectin was examined by ELISA before and after 2,4,8 weeks.All patients were recorded left ventricular mass（LVM） and left ventricular mass index（LVMI） by ultrasonic cardiograph.Results：Plasma adiponectin levels were higher in hemodialysis patients than normal;levels of adiponectin increased after EPO used 2 weeks,4 weeks after adiponectin levels further increased,the first 8 weeks with the first 4 weeks without significant change;The plasma CRP and SF levels were reduced after EPO uesed.Adiponectin is an important influence factor for LVMI.EPO can improve left ventricular hypertrophy and function.Conclusion：EPO in hemodialysis patients can increase adiponectin levels,lower CRP,SF levels of dialysis patients to reduce the risk of cardiovascular disease,to reduce left ventricular hypertrophy.