CAPD的内分泌激素与rHuEPO疗效的相关性

Relationship between Hormones and Effectiveness of Recombinant Human Erythropoietin in Uremic Patients Treated with CAPD

目的 :探讨在连续性非卧床腹膜透析 (CAPD)干预治疗下慢性肾衰竭尿毒症内分泌激素与人类重组促红细胞生成素 (rHuEPO)疗效的关系。方法 :对经CAPD治疗的慢性肾衰竭尿毒症患者内分泌激素等多重因素及血红蛋白进行多元回归分析。结果 :非CAPD组贫血改善程度显著低于CAPD组 ,内生肌酐清除率、甲状旁腺素、甲状腺激素、血皮质醇及透析治疗均与Hb显著相关。结论 :单用rHuEPO对改善肾衰竭尿毒症的贫血状态存在较大的局限 ,主要和包括PTH等在内的尿毒症红细胞生长抑制因子 (inhibitorsoferythropoiesis,IE)有关。rHuEPO配合CAPD是清除IE、改善贫血状态。

Objective:To investigate the relationship between hormones and effectiveness of recombinant human erythropoietin(rHuEPO) in anemic patients with end-stage renal disease treated with continuous ambulatory peritoneal dialysis (CAPD). Methods:In 40 patients with uremia, multivariate regression for analysis of the relationship between hormones and effectiveness of rHuEPO was performed. Results:Recombinant human erythropoietin corrected anemia significantly in uremic patients treated with CAPD. By multiple regression, the levels of parathyroid hormone, adrenocorticotropic hormone and free T 3 were significantly correlated with hemoglobin. Conclusion:Because of the inhibitors of erythropoisis including parathyroid hormone, recombinant human erythropoietin is less effective in uremic patients without CAPD. Combined treatment including rHuEPO and CAPD is necessary.