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目的考察前列腺素E1联合重组人红细胞生成素对尿毒症患者的肾性贫血疗效及对炎症因子的影响。方法收集2009年2月～2012年1月在某院治疗的尿毒症患者79例,随机分为2组:43例前列腺素E1联合重组人红细胞生成素组(试验组)和36例重组人红细胞生成素组(对照组),考察用药前后取血红蛋白(Hb)、血细胞比容(HCT)、血清铁蛋白(SF)、转铁蛋白饱和度(TSAT)和血浆C-反应蛋白(CRP)、白介素6(IL-6)和肿瘤坏死因子(TNF-α)。结果两个组别的性别、年龄、体重指数和病程相当,差异无统计学意义(P﹥0.05)。经治疗后两个组别Hb[(63.5±10.2)g/Lvs.(92.4±15.2)g/L,P﹤0.05;(65.9±12.7)g/Lvs.(100.7±11.9)g/L,P﹤0.05)]、HCT[(21.3±3.8)%vs.(26.8±3.6)%,P﹤0.05;(20.9±4.1)%vs.(29.5±4.1)%,P﹤0.05)]、SF[(126.5±75.3)ng/mlvs.(469.8±106.5)ng/ml,P﹤0.05;(131.1±64.9)ng/mlvs.(538.7±164.3)ng/ml,P﹤0.05)]和TSAT[(20.7±5.4)%vs.(29.6±5.4)%,P﹤0.05;(20.9±7.0)%vs.(32.6±3.0)%,P﹤0.05)]显著升高(P﹤0.05);与对照组比,Hb[(92.4±15.2)g/Lvs.(100.7±11.9)g/L,P﹤0.05)]、HCT[(26.8±3.6)%vs.(29.5±4.1)%)]、SF[(469.8±106.5)ng/mlvs.(538.7±164.3)ng/ml,P﹤0.05)]和TSAT[(29.6±5.4)%vs.(32.6±3.0)%,P﹤0.05)]升高明显。与治疗前比,对照组治疗后CRP、IL-6和TNF-α略有降低,但差异无统计学意义(P﹥0.05),试验组CRP[(5.6±1.5)mg/mlvs.(4.5±1.8)mg/ml]、IL-6[(7.2±1.6)pg/mlvs.(5.5±2.3)pg/ml]和TNF-α[(9.1±2.2)pg/mlvs.(7.1±5.1)pg/ml)]显著降低(P﹤0.05)。结论前列腺素E1联合重组人红细胞生成素对尿毒症患者能更有效改善患者贫血和缺铁,降低尿毒症患者的微炎症状态。
Objective To investigate the effect of prostaglandin E1 combined with recombinant human erythropoietin on renal anemia in patients with uremia and its effect on inflammatory factors. Methods 79 patients with uremia treated in a hospital from February 2009 to January 2012 were randomly divided into 2 groups: 43 prostaglandin E1 combined with recombinant human erythropoietin (experimental group) and 36 recombinant human erythrocytes (Hb), hematocrit (HCT), serum ferritin (SF), TSAT and CRP, interleukin 6 (IL-6) and tumor necrosis factor (TNF-α). Results There was no significant difference in gender, age, body mass index and duration between the two groups (P> 0.05). The levels of Hb in the two groups after treatment were (63.5 ± 10.2) g / L vs (92.4 ± 15.2) g / L, P <0.05; (65.9 ± 12.7) g / L vs (20.9 ± 4.1)% vs (29.5 ± 4.1)%, P <0.05)], SF [(21.3 ± 3.8)% vs (26.8 ± 3.6)%, P < (131.1 ± 64.9) ng / ml vs 538.7 ± 164.3 ng / ml, P <0.05) and TSAT [(20.7 ± (P <0.05). Compared with the control group, there was no significant difference between the two groups (P> 0.05); 5.4% vs 29.6 ± 5.4% P <0.05; 20.9 ± 7.0% vs 32.6 ± 3.0% Hb [(92.4 ± 15.2) g / L vs (100.7 ± 11.9) g / L, P <0.05)] and HCT [(26.8 ± 3.6)% vs P <0.05)] and TSAT [(29.6 ± 5.4)% vs (32.6 ± 3.0)%, P <0.05)]. Compared with before treatment, the CRP, IL-6 and TNF-α in the control group decreased slightly after treatment, but the difference was not statistically significant (P> 0.05). The CRP in the control group was (5.6 ± 1.5) mg / ml vs (7.1 ± 2.2) pg / ml vs. 7.1 ± 5.1 pg / ml], IL-6 [(7.2 ± 1.6) pg / ml vs. ml)] was significantly lower (P <0.05). Conclusions Prostaglandin E1 combined with recombinant human erythropoietin can effectively improve anemia and iron deficiency in patients with uremia and reduce the micro-inflammatory state in uremic patients.