重组人促红细胞生成素对血液透析患者营养状况和免疫功能的影响

目的:研究重组人促红细胞生成素对血液透析患者营养状态和免疫功能的影响。方法:选取2015年8月至2016年4月在我院进行维持性血液透析的患者共139名,随机分为对照组和观察组。对照组患者接受常规铁剂、叶酸等辅助治疗;观察组患者在常规治疗的基础上加用重组人促红细胞生成素。比较两组患者治疗前后血红蛋白、红细胞压积、营养状况(前白蛋白和转铁蛋白)以及免疫功能(CD4~+细胞、CD8~+细胞、CD4~+/CD8~+细胞和免疫球蛋白)等指标。结果:两组患者治疗前血红蛋白、红细胞压积、营养状况指标和免疫功能指标比较均没有统计学差异(P0.05)。治疗12周后,两组患者治疗后的血红蛋白、红细胞压积、前白蛋白、转铁蛋白均较治疗前显著升高(P0.05),且观察组患者以上指标较对照组升高更为明显(P0.05)。对照组患者治疗后的CD4~+细胞比例较治疗前明显升高(P0.05),但CD8~+细胞和CD4~+/CD8~+细胞比例没有显著变化(P0.05),而观察组治疗后这三类细胞的比例均较治疗前明显升高(P0.05)。观察组治疗后IgA、IgM和IgG浓度均较治疗前显著提升(P0.05),而对照组只有IgA和IgM浓度在治疗后有明显提高(P0.05),但仍显著低于观察组(P0.05)。结论:重组人促红细胞生成素能有效纠正血液透析患者的贫血情况,改善其营养状况并提高其免疫功能。

Impact of Recombinant Human Erythropoietin on the Nutritional Status and Immunity of Patients Undergoing Hemodialysis

ABSTRACT Objective: To investigate the effect of recombinant human erythropoietin on the nutritional status and immune function of hemodialysis patients. Methods: A total of 139 patients undergoing hemodialysis in our hospital from August 2015 to April 2016 were involved in this study. They were randomly divided into two groups, the control group and the observation group. Patients in the control group were given regular adjuvant therapy, such as oral iron and folic acid. And those in the observation group were given rhuEPO be- sides regular adjuvant therapy. The hemoglobin (Hb), hematocrit (Hct), nutritional status (prealbumin, PA and transferrin, TFR) and im- munity function (including the ratio of CD4⁺ cells, CD8⁺ cells and CD4⁺/CD8⁺ cells, and immunoglobulin) in two groups were compared before and after corresponding treatment. Results: There was no statistically significant difference in the hemoglobin, hematocrit, nutri- tional status and immune function between the two groups (P>0.05). After treatment for 12 weeks, the hemoglobin and hematocrit, preal- bumin and transferrin were significantly increased (P<0.05) After treatment, the above indexes in the observation group were significant- ly higher than those in the control group (P<0.05). The levels of prealbumin and transferrin were significantly higher in the two groups than in the control group (P<0.05), but the levels of prealbumin and transferrin in the observation group were significantly different from those in the observation group (P< 0.05). (P<0.05), but the ratio of CD4⁺/CD8⁺ cells showed no significant change (P>0.05); whilethe pro- portion of CD4⁺ cells in the control group was significantly higher than that before treatment The ratio of these three types of cells after treatment had significantly increased compared with before treatment (P<0.05). The IgA, IgM and IgG concentrations in the treatment group were significantly higher than those in the control group (P<0.05), only IgA and IgM in the control group was significantly in- creased after treatment (P<0.05), but were still lower than the observation group (P<0.05). Conclusion: Recombinant human erythropoi- etin could effectively correct the anemia of hemodialysis patients, improve the nutritional status, and improve the immune function.