抗氧化剂对尿毒症患者促红细胞生成素疗效影响的分析

Effect of Antioxidants on Erythropoietin Therapy and Microinflammation Status in Uremic Patients

目的探讨抗氧化剂对尿毒症维持性血液透析(MHD)患者促红细胞生成素(EPO)疗效及微炎症状态的影响。方法选择维持性血液透析患者51例,随机分为抗氧化剂治疗组和对照组,监测治疗前和治疗6个月后患者超敏C-反应蛋白(hs-CRP)、血红蛋白(Hb)、红细胞压积(Hct)、血清铁蛋白(SF)的变化,记录治疗前和治疗6个月后每周促红细胞生成素用量与红细胞压积的比值(EPO/Hct)的变化。结果治疗后与治疗前各组内对比,治疗组患者EPO/Hct、hs-CRP有所下降,对照组患者各指标无变化。治疗后两组间对比,抗氧化剂组EPO/Hct、hs-CRP低于常规治疗组,两组比较差异有统计学意义(P<0.05)。结论抗氧化剂治疗能够提高尿毒症维持性血液透析患者促红细胞生成素疗效及改善微炎症状态。

Objective To investigate the effect of antioxidants on erythropoietin therapy and microinflammation status in Ure- mic patients on maintenance hemodialysis. Methods 51patients on MHD were enrolled. They were randomly divided into Antiox- idants treatment group and control group. In each group, high sensitivity C-reactive protein, hemoglobin, hematocrit, serum ferrifin were measured before and after the treatment, the dose of erythropoietin in each week was recorded. The ratio of weekly EPO dos- age to Hct（EPO/Hct） were calculated. Results EPO/Hct, hs-CRP were decreased significantly after treatment in Antioxidants treatment group, there was no significant difference in control group. After 6 months treatment, the level of EPO/Hct, hs-CPR in Antioxidants treatment group were lower than those in control group, the difference between two groups was significant （ P 〈 0.05）. Conclusion The supplemental treatment with antioxidants was effective in reducing the reaction of oxidative stress and microinflammation, and improving the responsiveness to EPO in Uremia patients.