慢性肾衰竭血液透析患者EPO的疗效与ACEI关系的研究

The effects of ACE inhibitor treatment on erythropoiesis in chronic hemodialysis patients

目的 为了解CRF血液透析患者EPO治疗贫血的疗效与ACEI之间的关系。方法 对透析稳定、充分,伴有贫血与高血压患者,排除了缺铁、感染、铝中毒、继发性甲旁亢后,在应用EPO的同时,观察使用与不使用ACEI两组间贫血纠正的疗效。用随机对照的方法进行前瞻性的分析。结果 用ACEI组,EPO纠正贫血的达标率(Hb≥100g/L,Hct≥30％)为20.8％,不用ACEI组为55.5％。在用ACEI组达标的5例仅用ACEI10mg/d,未达标者ACEI用量较大,其中4例>40mg/d。结论 较大剂量的ACEI对EPO纠正贫血有一定的影响。

Objective To evaluate the effects of ACE inhibitor treatment on erythropoiesis in chronic hemodialysis patients. Methods 51 hemodialysis patients with anemia and hypertension, rule of iron deficiency, infection , aluminum intoxication and hyperparathyroidism were divided into 2 groups, based on whether or not they were administered ACEI, into the ACEI group(n = 24) and the non - ACEI group(n = 27) , and prospective randomised comparisons were made of hematocrit(Hct) and hemoglobin (Hb). Results Among the patients in the non - ACEI group, the percentage of the patients achieving a hemoglobin response,defined as an increase> or= 100g/L,hemotocrit > or = 30% was 55.5% . While in the ACEI group ,the percentage was 20.8% . the dose of ACEI in 5 patients achieving hemoglobin response were 10mg/d for each, but in 4 patients not achieving hemoglobin response were > 40 mg/d for each. Conclusion Large dose of ACEI may decrease hemoglobin in chronic hemodialysis patients.