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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(P>0.05)。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(P<0.05),且观察组患者以上指标较对照组升高更为明显(P<0.05)。对照组患者治疗后的CD4~+细胞比例较治疗前明显升高(P<0.05),但CD8~+细胞和CD4~+/CD8~+细胞比例没有显著变化(P>0.05),而观察组治疗后这三类细胞的比例均较治疗前明显升高(P<0.05)。观察组治疗后IgA、IgM和IgG浓度均较治疗前显著提升(P<0.05),而对照组只有IgA和IgM浓度在治疗后有明显提高(P<0.05),但仍显著低于观察组(P<0.05)。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。
Objective: To study the effect of recombinant human erythropoietin on nutritional status and immune function in hemodialysis patients. Methods: A total of 139 patients undergoing maintenance hemodialysis in our hospital from August 2015 to April 2016 were randomly divided into control group and observation group. Patients in the control group received routine iron supplementation and folate supplementation, while patients in the observation group received recombinant human erythropoietin on the basis of routine treatment. Hemoglobin, hematocrit, nutritional status (prealbumin and transferrin) and immune function (CD4 ~ + cells, CD8 ~ + cells, CD4 ~ + / CD8 ~ + cells and immunoglobulin) were compared between the two groups before and after treatment And other indicators. Results: There was no significant difference in hemoglobin, hematocrit, nutritional status and immune function between the two groups before treatment (P> 0.05). After 12 weeks of treatment, hemoglobin, hematocrit, prealbumin and transferrin in both groups after treatment were significantly higher than those before treatment (P <0.05), and the above indexes in the observation group were more elevated than those in the control group Obviously (P <0.05). The proportion of CD4 ~ + cells in the control group was significantly higher than that before treatment (P <0.05), but there was no significant change in the proportion of CD8 ~ + cells and CD4 ~ + / CD8 ~ + cells (P> 0.05) After treatment, the proportion of these three types of cells were significantly higher than before treatment (P <0.05). The levels of IgA, IgM and IgG in the observation group were significantly higher than those before treatment (P <0.05), but only the levels of IgA and IgM in the control group were significantly increased after treatment (P <0.05), but still significantly lower than those in the observation group P <0.05). Conclusion: Recombinant human erythropoietin can effectively correct the anemia in hemodialysis patients, improve their nutritional status and enhance their immune function.