摘要
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。
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 November 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 influence 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 independent 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.
出处
《中国全科医学》
CAS
CSCD
北大核心
2014年第15期1700-1703,共4页
Chinese General Practice
基金
广西壮族自治区教育厅科研立项(201106LX116)
广西壮族自治区卫生厅自筹经费科研课题(桂卫Z2009099)
关键词
肾透析
红细胞生成素
重组
超敏C反应蛋白
阿托伐他汀钙
Renal dialysis
Erythropoietin
recombinant
High sensitivity C-reactive protein
Atorvastatin
