基因重组促红细胞生成素对血透患者一氧化氮、内皮素影响的研究

Effect of Recombinant Human Erythropoietin on Nitric Oxide, Endothelin-1 in Chronic Hemodiaiysis Patients

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物质一氧化氮(NO)、内皮素-1(ET-1)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=43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=23)、HDepo血压正常亚组(HDepo-2组,n=20)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20例(NHD组)、原发性高血压患者20例、健康对照组34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、用放射免疫法测定血ET-1水平。结果:尿毒症未透析患者血清NO、ET-1水平明显高于正常对照组,P<0.001;尿毒症透析患者血清NO、ET-1浓度较正常对照组高,P<0.001,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、血清ET-1水平较未透析者高,P<0.05;HDepo组经rHuEpo治疗3月后,血NO浓度降低,血ET-1浓度增高,与用药前及对照组比较,P<0.05。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<0.001,血压增高与血NO浓度的降低、血ET-1浓度增高有相关性。结论:rHuEpo可使尿毒症透析患者血NO浓度降低、血ET-1浓度增高。

Objective: To investigate the effect of recorabinant Human erythropoietin(rhuEpo) on Nitric Oxide (NO) and Endothelih-l(ET-l) in ehroic hemodialysis patients. Methods:Eighty patients on chronic hemodialysis were involoved in the randomized, controlled observation. Forty three received rhuEpo(HDepo n=43), thirty seven did not(HD n=37). According to the blood pressure of these patients, each group was divided into two groups further, HDepo with hypertension (HDepo-1 group, n=23), HDepo with normal blood pressure (HDepo-2group, n=20), HD with hypertension(HD-l group,n=19), HD with normal blood pressure (HD-2group,n=18), twenty uremia patients did not receive hemodialysis therapy and twenty primary hypertension patients,thirty-four normal adults were chosen as control group (CON.group). The NO level was detected by colorimetry.The ET-1 level were detected by radioimmunoassary (RIA). Results: The NO level and ET-1 level in serum of uremia patients did not receive HD therapy were significantly higher than those in normal control group (P<0.001). The NO level, ET-1 level level in uremia patients receive HD therapy were higher than those in normal control group(P<0.05),The No level in serum in hemodialysis patients was higher than those patients who did not receive hemodialysis therapy.The ET-1 level were higher than those patients who did not receive hemodialysis patients.(P<0.05).After three months'therapy, the NO consistency in serum in HD group declined after the rHuepo therapy (P<0.001), and it was lower than that of normal control group (P<0.05).While the ET-1 consistency raised. After the therapy, diastolic pressure, systolic pressure, mean arterial pressure of HDepo group were all higher than those of HD group (P<0.001), the rising of blood pressure corrlated with the decline of the NO consistencyjaising of ET-1 consistency. Conclusion: Erythropoietin can reduce the consistency of NO in serum in chronic urinemia hemodialysis patients.It also can increase the ET-1 consistency.Hypertension caused by rhuEpo relate with the decline of the NO consistency, and increase of ET-1 consistency.