坎地沙坦+促红细胞生成素联合治疗血液透析患者贫血的作用

Effect of candesartan for erythropoietin on nephrotic anemia in patients undergoing maintenance hemodialysis

目的观察坎地沙坦治疗血液透析患者贫血中的作用。方法将40例维持性血液透析(maintenance hemodi-alysis,MHD)患者随机分成治疗组和对照组,每组20例;治疗组以坎地沙坦联合促红细胞生成素治疗,对照组仅用促红细胞生成素治疗。检测治疗前及治疗6个月后的血清C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血红蛋白(Hb)和血细胞比容(Hct)水平。结果治疗6个月后,治疗组CRP、IL-6、TNF-α水平均较治疗前明显下降,Hb和Hct水平均较治疗前明显升高,差异均有统计学意义(P<0.05);而对照组治疗前后则无明显变化。同时治疗后治疗组与对照组比较差异有统计学意义(P<0.05)。结论坎地沙坦联合促红细胞生成素可以更好地改善维持性血液透析患者的贫血状况,其机制可能是通过改善患者微炎性反应实现的。

Objective To investigate the effect of candesartan for erythropoietin on nephrotic anemia in maintenance hemodial- ysis patients（MHD）. Methods Forty patients with MHD were randomly divided into two groups：treatment group（ n = 20）and control group（n = 20）. Patients in the treatment group were daffy given candesartan combined with erythropoietin while patients in the cuntrol group were given erythropoietin only. C - reactive protein （ CRP）, interlukin - 6 （ IL - 6 ）, tmnor necrosis factor alpha （ TNF - α ） and haematoglobin（Hb） were assayed before treatment and after six months of treatment. Results After 6 months of treatment,the level of serum CRP, IL -6 and TNF -cxdecreased significantly in the treatment group（P 〈 0.05 ） ,while Hb and Hct in the treatment group in- creased remarkably（P 〈 0. 05）. However, there were no significant changes in the control group before and after treatment. There was significant difference between the combined treatment group and the control group（P 〈 0. 05）. Conclusions Candesartan combined with erythropoietin improves symptoms of nephrotic anemia,the mechanism of which may be the relief of the microinflammatory reaction in MHD patients.