重组促红细胞生成素对血透患者NO的影响研究

Effect of Recombinant Human Erythropoietin on Serum Nitric Oxide Contents in Patients on maintenance Hemodiaiysis

目的 :探讨基因重组促红细胞生成素 (rHuEpo)对维持性血透患者血管活性介质一氧化氮 (NO)的影响。方法 :将长期规律性血透尿毒症患者 80例分为血液透析应用rHuEpo者 (HDepo组n =4 3例 ) ,血液透析不应用rHuEpo者 (HD组n =37例 ) ,根据血压情况两组再分为HDepo高血压亚组 (HDepo - 1组 ,n =2 3)、HDe po血压正常亚组 (HDepo - 2组 ,n =2 0 )和HD高血压亚组 (HD - 1组 ,n =19)、HD血压正常亚组 (HD - 2组 ,n =18)。另选尿毒症未透析患者 2 0例 (NHD组 )、原发性高血压患者 2 0例、健康对照组 35例 (CON组 )。HDepo组患者均接受rHuEpo治疗 3个月以上 ,用比色法测定血NO水平。结果 :尿毒症未透析患者血清NO水平明显高于正常对照组 ,p <0 0 0 1;尿毒症透析患者血清NO浓度较正常对照组高 ,p <0 0 0 1,但经透析治疗的尿毒症患者与尿毒症未透析者比较 ,血清NO水平较未透析者低 ,p <0 0 5 ;HDepo组经rHuEpo治疗三月后血NO浓度下降 ,与用药前及对照组比较 ,p<0 0 0 1,p <0 0 5。且用rHuEpo治疗后 ,HDepo组收缩压、舒张压、平均动脉压均较HD组高 ,p <0 0 0 1,血压增高与NO浓度的降低有相关性。结论 :rHuEpo可使尿毒症透析患者血NO浓度降低 。

Objective To investigate the effect of recombinant human erythropoietin(rhuEpo) on the serumnitric oxide(NO) content in patients on maintenance hemodialysis. Methods Eighty patients on chronic dialysis were divided into two groups: 43 received rhuEpo (HDepo) and 37 did not (HD). Each group consisted of two sub-groups: HDepo-1, with hypertension, n=23; HDepo-2, without hypertension, n=19; HD-1, with hypertension, n=19 and HD-2, without hyperteusion, n=18. Twenty uremic patients without hemodialysis, twenty patients with essential hypertension and 34 normal adult were chosen for control study. Serum content of NO was measured with RIA in all these subjects. Results Serum contents of NO in uremic patients without bemodialysis were significantly higher than those in the 34 normal controls ( p <0 001). Serum NO contents in patients with dialysis were still higher than those in controls ( p <0 001), but were lower than those in patients without dialysis ( p <0 05). The NO contents in dialysed patients after rhuEpo therapy for three months were significantly lower than those in patients before dialysis and in controls ( p <0 001, p <0 05 respectively). Moreover, the diastolic pressure systolic pressure and mean arterial pressure in patients of HDepo group were all significantly higher than those in patients of HD group ( p <0 001), the rising of blood pressure being correlated to the lowering of serum NO content. Conclusion Erythropoietin treatment can reduce the serum NO content in chronic uremic patient on dialysis. Hypertension caused by rhuEpo is related to the lowering of the NO content.