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目的：探讨基因重组促红细胞生成素（ｒ－ＨｕＥＰＯ）在治疗慢性肾衰（ＣＲＦ）贫血中导致高血压的机制及防治对策。方法：对ｒ－ＨｕＥＰＯ治疗中出现高血压ＣＲＦ血液透析贫血患者１５例及对照组１５例，ＣＲＦ贫血动物模型，以及透析过程中出现低血压的３４例患者，应用分光光度法及放免法观察用药或透析前后血浆一氧化氮（ＮＯ）代谢产物（ＮＯ２／ＮＯ３）及内皮素－１（ＥＴ－１）的变化。结果： ①ＣＲＦ贫血患者及贫血鼠用ｒ－ＨｕＥＰＯ治疗１６周后，红细胞压积（Ｈｃｔ）升高，血压升高，ＥＴ－１升高（Ｐ＜０．０１），血浆ＮＯ２／ＮＯ３下降（Ｐ＜０．０１），而对照组用药前后无明显变化（Ｐ＞０．０５）。②在用药１６周后，ＲＴ－ ＰＣＲ测得实验组大鼠肾皮质及髓质ｉＮＯＳｍＲＮＡ比对照组明显减少（Ｐ＜０．０５）。③透析低血压患者透析后ＮＯ２／ＮＯ３含量增高，ＥＴ－１含量减少（Ｐ＜０．０５）。结论：研究表明ｒ－ＨｕＥＰＯ导致高血压与ｉＮＯＳｍＲＮＡ减少、合成ＮＯ减少和ＥＴ－１增加有重要的关系。
Objective: To investigate the mechanism of r-HuEPO in the treatment of hypertension induced by chronic renal failure (CRF) and its prevention and treatment. Methods: 15 cases of hypertensive CRF hemodialysis anemia and 15 cases of control group, CRF anemia animal model and 34 cases of hypotension during dialysis were treated with r-HuEPO. The patients were treated with spectrophotometry and radioimmunoassay (NO2 / NO3) and endothelin-1 (ET-1) before and after dialysis. Results: ① After 16 weeks treatment with r-HuEPO in CRF anemia and anemia rats, hematocrit (Hct) increased, blood pressure increased, ET-1 increased (P <0.01), plasma NO2 / <0.01), while there was no significant difference in the control group before and after treatment (P> 0.05). ② After 16 weeks of treatment, iNOS mRNA in renal cortex and medulla decreased significantly (P <0.05) in experimental group compared with control group by RT-PCR. ③ The level of NO2 / NO3 increased and the content of ET-1 decreased after dialysis in patients with dialysis hypotension (P <0.05). CONCLUSIONS: Studies have shown that r-HuEPO leads to hypertension and has a significant relationship with reduced iNOS mRNA, reduced synthesis of NO and increased ET-1.