CAJ | 학술논문

目的：探讨低剂量阿托伐他汀钙对维持性血液透析（MHD）患者重组人促红细胞生成素（ rHuEPO）用量的影响。方法选取2011年11月-2012年11月在广西医科大学第一附属医院血液净化中心行 MHD 患者36例，将连续3个月服用低剂量（10 mg/ d）阿托伐他汀钙治疗的18例患者作为观察组，未服用阿托伐他汀钙治疗的18例患者作为对照组。比较两组患者治疗前及治疗3个月后血脂、血红蛋白（Hb）、超敏 C 反应蛋白（hs - CRP）水平及促红细胞生成素反应指数（ERI）、平均 rHuEPO 用量。以 ERI 治疗后与治疗前差值（ΔERI）作为应变量，采用多重线性逐步回归法分析影响ΔERI 的因素。结果两组患者治疗前血脂、Hb、hs - CRP、ERI、平均 rHuEPO 用量间无差异（P>0.05）；治疗后观察组患者的总胆固醇（TC）、高密度脂蛋白胆固醇（HDL - C）、低密度脂蛋白胆固醇（LDL - C）、hs - CRP、ERI、平均 rHuEPO 用量均低于对照组（P <0.05），而 Hb 水平则高于对照组（P <0.05）。多重线性回归分析显示，阿托伐他汀钙、ΔHb 和ΔTC 是ΔERI 的独立影响因素（β值分别为3.62、-0.26、0.99，均 P <0.05）。结论给予 MHD 患者低剂量阿托伐他汀钙治疗，可以提高患者 Hb 水平，降低 hs - CRP 水平及 ERI，并减少 rHuEPO 用量。
목적：탐토저제량아탁벌타정개대유지성혈액투석（MHD）환자중조인촉홍세포생성소（ rHuEPO）용량적영향。방법선취2011년11월-2012년11월재엄서의과대학제일부속의원혈액정화중심행 MHD 환자36례，장련속3개월복용저제량（10 mg/ d）아탁벌타정개치료적18례환자작위관찰조，미복용아탁벌타정개치료적18례환자작위대조조。비교량조환자치료전급치료3개월후혈지、혈홍단백（Hb）、초민 C 반응단백（hs - CRP）수평급촉홍세포생성소반응지수（ERI）、평균 rHuEPO 용량。이 ERI 치료후여치료전차치（ΔERI）작위응변량，채용다중선성축보회귀법분석영향ΔERI 적인소。결과량조환자치료전혈지、Hb、hs - CRP、ERI、평균 rHuEPO 용량간무차이（P>0.05）；치료후관찰조환자적총담고순（TC）、고밀도지단백담고순（HDL - C）、저밀도지단백담고순（LDL - C）、hs - CRP、ERI、평균 rHuEPO 용량균저우대조조（P <0.05），이 Hb 수평칙고우대조조（P <0.05）。다중선성회귀분석현시，아탁벌타정개、ΔHb 화ΔTC 시ΔERI 적독립영향인소（β치분별위3.62、-0.26、0.99，균 P <0.05）。결론급여 MHD 환자저제량아탁벌타정개치료，가이제고환자 Hb 수평，강저 hs - CRP 수평급 ERI，병감소 rHuEPO 용량。
Objective To investigate the effects of low - dose atorvastatin on recombinant human erythropoietin (rHuEPO)dosage among patients undergoing maintenance hemodialysis(MHD). Methods A total of 36 patients undergoing MHD at centre of blood purification in the First Affiliated Hospital of Guangxi Medical University from November 2011 to Novem-ber 2012,were selected as study subjects,among whom 18 patients who received atorvastatin therapy(10 mg/ d for 3 months) were selected as observation group,and 18 other patients who did not receive atorvastatin therapy were selected as control group. The levels of blood cholesterol,hemoglobin(Hb)and high sensitivity C - reactive protein(hs - CRP),erythropoietin resistance index( ERI)and rHuEPO dosage before treatment and 3 months after treatment were compared between the two groups. The dependent variable was the difference value(ΔERI)between ERI before treatment and ERI after treatment,the in-fluence factors of ΔERI were analyzed by generalized linear stepwise regression. Results There was no significant difference in levels of blood cholesterol,Hb and hs - CRP,ERI and rHuEPO dosage between two groups before treatment(P > 0. 05). After treatment,the levels of TC,HDL - C,LDL - C and hs - CRP,ERI and rHuEPO dosage in observation group were significantly lower than those in control group(P < 0. 05),Hb level in observation group was significantly higher than that in control group (P < 0. 05). The generalized linear stepwise regression analysis results showed that atorvastatin,ΔHb and ΔTC were independ-ent influence factors of the ΔERI( β value was 3. 62, - 0. 26 and 0. 99,respectively,all P < 0. 05). Conclusion Low -dose atorvastatin therapy for MHD patients can increase hemoglobin level,decrease hs - CRP level and ERI,and reduce the rHuEPO dosage.