血管紧张素Ⅱ受体拮抗药及血管紧张素转换酶抑制剂对血液透析患者重组人红细胞生成素疗效的影响

Influence of ARB and ACEI on the therapeutic effects of r-HuEPO in hemodialysis patients

目的观察血管紧张素Ⅱ受体拮抗药(ARB)和血管紧张素转换酶抑制剂(ACEI)对维持性血液透析(MHD)的终末期肾衰竭(ESRF)患者应用重组人红细胞生成素(r-HuEPO)对贫血疗效的影响。方法根据行MHD的ESRF患者所用降压药的不同将其分为以下三组:r-HuEPO+ACEI组15例,r-HuEPO+ARB组15例,对照组15例(r-HuEPO+钙离子拮抗药);检测用药第0、4、8、16周时的红细胞(RBC)计数及血红蛋白(Hb)。结果 r-HuEPO+ACEI组与r-HuEPO+ARB组在治疗0、4、8、16周时的RBC、Hb值组内比较,差异无统计学意义(P>0.05),组间比较差异无统计学意义(P>0.05);而对照组治疗16周后的RBC、Hb均明显较治疗前增高(P<0.05),与r-HuEPO+ACEI组、r-HuEPO+ARB组治疗16周比较,差异均具有统计学意义(P<0.05)。结论 ARB及ACEI均可影响r-HuEPO治疗贫血的疗效。

Objective To observe the influence of angiotensin Ⅱ receptor antagonist（ARB） I and angiotensin- converting enzyme inhibitors（ACEI） on the efficacy of recombinant human erythropoietin（r-HuEPO） for improving anemia in the maintenance hemodialysis（MHD） patients with end-stage renal failure（ESRF）. Methods MHD pa- tients with ESRF were divided into 3 groups according to using the different antihypertensive drugs： r-HuEPO ＋ ACEI group（15 cases） ,r-HuEPO ＋ ARB group（15 cases） and the control group（r-HuEPO ＋ calcium antagonists, 15 cases）. The RBC counting and hemoglobin（Hb） were detected before treatment and in 0,4,8, 16 weeks after treatment. Results The values of RBC counting and Hb in 0,4,8,16 weeks after treatment had no statistically sig- nificant differences in the intra-group comparison and the inter-group comparison of the r-HuEPO＋ACEI group and the r-HuEPO＋ARB group（P〉0.05）. RBC counting and Hb after 16-week treatment in the control group were sig- nificantly higher than that before treatment（P〈0.05）, compared with the r-HuEPO＋ ACEI group and the r-HuEPO ＋ARB group,the differences were statistically significant（P d0.05）. Conclusion ARB and ACEI may affect the ef- ficacy of r-HuEPO for treating anemia.