外源性EPO治疗肾性贫血患者相关红细胞参数研究

Study of Related Erythrocyte Parameters of Renal Anemia Patient Treated by Exogenous EPO

目的 通过分析肾性贫血患者经外源性促红细胞生成素（EPO）治疗后相关血细胞参数（血红蛋白、红细胞比容、网织红细胞计数、网织红细胞生成指数等）水平及其之间的关系,为临床治疗肾性贫血提供依据.方法 肾性贫血组61例,非肾性贫血组59例,对照组64例.采用酶联免疫吸附试验（ELISA）同时检测各组EPO水平,采用Sysmex XE-2100型血细胞分析仪检测血红蛋白（HGB）、网织红细胞百分率（Ret%）、低荧光网织红细胞比率（LFR%）、中荧光网织红细胞比率（MFR%）、高荧光网织红细胞比率（HFR%）和红细胞比容（HCT）.结果 同对照组相比,肾性贫血组EPO,HGB和HCT水平显著降低,差异有统计学意义（t=2.639,2.179,2.201;P均＜0.05）;非肾性贫血组HGB和HCT水平显著降低,EPO水平显著升高,差异有统计学意义（t=2.074,2.819,2.145;P＜0.05）;给予肾性贫血患者外源性EPO治疗后,治疗有效组46例,治疗无效组15例,治疗有效组HGB,RET,HFR,MFR和HCT水平升高,差异有统计学意义（t=2.112,2.132,2.160,2.029,2.159;P均＜0.05）,LFR差异无统计学意义（t=1.866,P＞0.05）;治疗无效组RET,LFR显著升高,差异有统计学意义（t=2.248,2.124;P＜0.05）,HGB,HFR,MFR和HCT差异无统计学意义（t=1.903,1.898,1.919,1.834;P＞0.05）.结论 肾性贫血患者相关红细胞参数的研究,有助于分析研究肾性贫血患者给予外源性EPO治疗后,患者骨髓红系生长情况,从而为临床医师采取相应的治疗方式改善贫血提供依据.

Objective Detecting the level of erythrocyte parameters （hemoglobin, hematocrit, rcticuloeyte count, reticulocyte production index et al） of nephropathy dialysis patients,to provide the basis of correct treatment. Methods 61 cases of ne-phropathy dialysis patients,59 cases of non-nephropathy dialysis patients, 64 cases of controls were collected. The level of EPO was detected bydouble antibody sandwich principle enzyme-linked immunosorbent assay （ELISA） ,and the level of he-moglobin （HGB）, reticulocyte percentage （Ret%）, immature reticulocyte ratio （IRF%）, low fluorescent reticulocyte ratio （ LFR% ）, fluorescent reticulocyte ratio （MFR%）, high fluorescent reticulocyte ratio （ HFR% ）, and hematocrit （HCT） were detected by Sysmex XE-2100 type blood cell analyzer. Results Compared to control group, the levels of EPO, HGB and HCT of renal anemia group were reduced significantly （t=2. 639,2. 179,2. 201;P〈0. 05）, the level of HGB, HCT of non-renal anemia group were reduced significantly （P〈0.05）,the level of EPO was increased significantly （t= 2. 074,2. 819, 2. 145;P〈0. 05）;Furthermore,given to patients with exogenous EPO treatment, 46 cases were effective and 15 cases were invalid. In the effective group, the levels of H GB, HFR, MFR, IRF and HCT were increased significantly （t=2.112,2. 132, 2.160,2.029,2.159 ; P〈0. 05 ）, and the level of LFR showed no significant change （t = 1. 866, P〉 0.05）. In the invalid group,the levels of RET and LFR were increased significantly （t=2. 248,2. 124;P〈0. 05）,the levels of HGB, HFR,MFR and HCT showed no significant change （t=1. 903,1. 898,1. 919,1. 834;P〉0.05）. Conclusion The EPO level and related erythrocyte parameters detection are helpful to find out bone marrow erythroid growth situation for renal anemia patients given exogenous EPO,and to provide the basis for clinical diagnosis and treatment.