CAJ | 학술논문

目的观察血管紧张素转换酶抑制剂(ACEI)对维持性血液透析患者贫血和促红细胞生成素(EPO)用量的影响.方法 90例维持性血液透析合并高血压和贫血的患者,按随机数字表法分为观察组和对照组,每组45例,观察组使用ACEI降血压治疗,对照组使用钙离子拮抗剂(CCB)降血压治疗.比较两组患者在0、2、4、6、8、10、12个月时的血红蛋白、EPO用量、血清EPO.结果观察组的血红蛋白逐渐下降,6个月及之后与对照组比较差异有统计学意义[6个月:(94.21±9.20)g/L比(105.55±9.16)g/L;12个月:(95.90±6.75)g/L比(105.81±4.45)g/L;P<0.05];观察组EPO用量逐渐上升,8个月及之后与对照组比较差异有统计学意义[8个月:(10090.75±1918.35)U/周比(7010.32±1600.15)U/周;12个月:(11 586.39±2009.76)U/周比(7068.48±1615.35)U/周,P<0.05].在整个研究期间,两组患者的血清EPO水平均保持稳定不变.结论 ACEI治疗会加重维持性血液透析患者的贫血和降低EPO的疗效.
목적 관찰혈관긴장소전환매억제제(ACEI)대유지성혈액투석환자빈혈화촉홍세포생성소(EPO)용량적영향.방법 90례유지성혈액투석합병고혈압화빈혈적환자,안수궤수자표법분위관찰조화대조조,매조45례,관찰조사용ACEI강혈압치료,대조조사용개리자길항제(CCB)강혈압치료.비교량조환자재0、2、4、6、8、10、12개월시적혈홍단백、EPO용량、혈청EPO.결과 관찰조적혈홍단백축점하강,6개월급지후여대조조비교차이유통계학의의[6개월:(94.21±9.20)g/L비(105.55±9.16)g/L;12개월:(95.90±6.75)g/L비(105.81±4.45)g/L;P<0.05];관찰조EPO용량축점상승,8개월급지후여대조조비교차이유통계학의의[8개월:(10090.75±1918.35)U/주비(7010.32±1600.15)U/주;12개월:(11 586.39±2009.76)U/주비(7068.48±1615.35)U/주,P<0.05].재정개연구기간,량조환자적혈청EPO수평균보지은정불변.결론 ACEI치료회가중유지성혈액투석환자적빈혈화강저EPO적료효.
Objective To observe the effect of angiotensin-converting enzyme inhibitors (ACEI) on anemia and erythropoietin (EPO) requirements in maintenance hemodialysis patients. Methods Ninety maintenance hemodialysis patients with hypertension and anemia were divided into 2 groups by random digits table, observation group (45 cases, using ACEI as antihypertensive treatment), control group [45 cases,using calcium channel blocker (CCB) as antihypertensive treatment]. The follow-up period after starting ACEI or CCB therapy was one year. The hemoglobin concentration, serum EPO, EPO requirements were compared after 0, 2, 4, 6, 8, 10, 12 months' treatment. Results In response to ACEI, the mean hemoglobin value in observation group decreased progressively, reaching statistical significance after 6 months, and it had significant difference compared with that in control group [6 months: (94.21±9.20) g/Lvs. (105.55±9.16) g/L,12 months: (95.90±6.75) g/L vs. (105.81±4.45) g/L,P <0.05]. The EPO requirements experienced a progressive increase in observation group and reached statistical significance after 8 months, compared with those in control group [8 months: ( 10 090.75±1918.35) U/week vs. (7010.32±1600.15) U/week, 12 months: (11 586.39±2009.76) U/week vs. (7068.48±1615.35) U/week,P<0.05].Serum erythropoietin concentration remained stable during the study in two groups. Conclusion ACEI can worsen anemia and reduce the efficacy of EPO in maintenance hemodialysis patients.