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目的探讨他汀类药物对维持性血液透析患者微炎症状态及促红细胞生成素低反应性的影响。方法 286例行维持性血液透析患者中应用他汀类药物治疗者68例为治疗组,未应用他汀类药物治疗者218例为对照组。比较2组治疗前、后血清高敏C反应蛋白、血清铁蛋白、血红蛋白水平及每周促红细胞生成素用量。结果治疗组血清高敏C反应蛋白治疗后(1.23±1.11)mg/L较治疗前(1.58±1.49)mg/L降低(P<0.05),对照组治疗前(1.93±1.22)mg/L与治疗后(2.10±1.77)mg/L比较差异无统计学意义(P>0.05);治疗组平均每周促红细胞生成素用量(30.60±24.50)u/kg明显低于对照组(47.30±31.20)u/kg(P<0.05),且促红细胞生成素反应指数(2.82±1.73)低于对照组(4.51±3.48),差异有统计学意义(P<0.05);多元逐步回归分析显示,性别、hs-CRP、透析时间、血清铁蛋白及他汀类药物治疗是促红细胞生成素反应指数的独立影响因子。结论他汀类药物可改善维持性血液透析患者微炎症状态,并减少患者促红细胞生成素的用量。
Objective To investigate the effect of statins on the micro-inflammatory status and the erythropoietin low reactivity in maintenance hemodialysis patients. Methods 286 routine maintenance hemodialysis patients with statins in 68 patients as the treatment group, 218 patients without statin therapy as the control group. The levels of serum high-sensitivity C-reactive protein, serum ferritin, hemoglobin and weekly erythropoietin were compared between the two groups before and after treatment. Results Compared with the control group before treatment (1.93 ± 1.22) mg / L and before treatment (1.58 ± 1.49) mg / L, the level of serum high sensitive C - reactive protein in treatment group was significantly lower (2.10 ± 1.77) mg / L, there was no significant difference between the two groups (P> 0.05). The average weekly dosage of erythropoietin (30.60 ± 24.50) u / kg in the treatment group was significantly lower than that in the control group (47.30 ± 31.20) u / kg (P <0.05), and the response index of erythropoietin (2.82 ± 1.73) was lower than that of the control group (4.51 ± 3.48) (P <0.05). Multivariate stepwise regression analysis showed that gender, -CRP, dialysis time, serum ferritin, and statin therapy are independent influencing factors for erythropoietin response index. Conclusion Statins can improve the micro-inflammatory status of maintenance hemodialysis patients and reduce the dosage of erythropoietin in patients.