促红细胞生成素对血液透析患者血液流变学的影响

Effects of Erythropoietin for Renal Anemia on Blood Rheology of Maintenance Hemodialysis Patients

目的 了解应用促红细胞生成素 (EPO)治疗肾性贫血对尿毒症维持性透析患者血液流变学的影响。方法 于EPO治疗前及治疗后 4周、2 4周分别检查新进入维持性血透的 2 7名患者的Hb、HCT及血液流变学指标 ,同时观察血压、肝素用量及内瘘等。结果 患者EPO治疗前 ,全血高切、低切粘度均低于正常对照组 ,EPO治疗后 ,Hb及HCT逐渐升高 ,且随治疗时间延长升高 ,在治疗 4周及 2 4周时相差均显著 (P <0 .0 5 )。血浆粘度治疗前高于正常组 ,但相差不显著 ,且随EPO治疗无显著改变 (P <0 .0 5 )。红细胞聚集指数及纤维蛋白原明显高于正常组 (P <0 .0 5 ) ,随EPO治疗有升高趋势 ,但相差也不显著 (均P >0 .0 5 )。EPO治疗后患者高血压发生率及肝素用量均显著升高 (P <0 .0 5 )。结论 EPO治疗可致全血粘度升高 ,主要与贫血改善有关 。

Object:To study the effect of erythropoietin for renal anemian on blood viscosity of maintenance hemodialysis patients.Method:Hemoglobin(Hb),hematocrit(HCT)and blood rheology of 27 chronic renal failure patients before of heparin needed were also observed.Results:Hb and HCT inhcreased significantly with the therapy of EPO.Whole blood viscosity and low shear viscosity were lower than those of normal controls and increased significantly after 4 or 24 weeks EPO therapy.However,plasma viscosity had no significant change.Red blood cell aggregation index and plasma fibrinogen were higher than normal before the initiation of dialysis and but both had no significant increase after treatment with EPO.The incidence of hypertension increases and all patients need more heparin with the use of EPO.Conclusion:EPO may lead to increased whole blood viscosity,but the plasma viscosity was not significantly affected.