可溶性促红细胞生成素受体在肾性贫血中的临床意义

摘要

Objective To investigate the clinical significance of soluble erythropoietin receptor ( sEPOR) in renal anemia(RA).Methods A total of 136 patients with RA and treated by erythropoietin(EPO)were enrolled.According to the degrees of anemia , they were classified into severe anemia group [ hemoglobin ( Hb ) <60 g/L ] and mild-to-moderate anemia group ( Hb 60-120 g/L) .A total of 100 healthy subjects undergoing a medical examination in Medical Center during the same period were enrolled as control group .The levels of sEPOR and the complexes of EPO/sEPOR were determined by enzyme-linked immunosorbent assay ( ELISA ) .The level of parathyroid hormone ( PTH ) was determined by electrochemical immunoassay , the level of creatinine (Cr) was determined by picric acid method , and the results were analyzed statistically .Results Compared with the control group , the patients with severe and mild-to-moderate anemia had higher levels of sEPOR , the complexes of EPO/sEPOR, PTH and Cr ( P<0.05).There was a good correlation of sEPOR and Hb in severe anemia group (r =-0.650,P <0.05), and there was no obvious correlation in mild-to-moderate anemia group(r=0.135,P<0.05).Conclusions The sEPOR level of patients with RA is higher that of control group .Peripheral blood sEPOR and EPO can be formed complexes .This study suggests that sEPOR is significant in the further research and clinical treatment of RA .%目的：探讨可溶性促红细胞生成素受体（ sEPOR）在肾性贫血（ RA）中的临床意义。方法选择136例采用促红细胞生成素（ EPO）治疗的RA患者作为RA组，以同期体检中心接受体检的100名健康者作为对照组。 RA患者按贫血程度分为重度贫血组[血红蛋白（ Hb）＜60 g／L]及轻中度贫血组（ Hb 60～120 g／L）。用酶联免疫吸附试验（ELISA）分别检测RA组和对照组外周血sEPOR和EPO／sEPOR复合物，用电化学发光法检测外周血甲状旁腺素（PTH），用苦味酸法检测血清肌酐（Cr），并进行统计学分析。结果与对照组比较，RA轻中度贫血组和重度贫血组sEPOR、EPO／sEPOR复合物、PTH、Cr浓度差异有统计学意义（P＜0．05）。在重度贫血组sEPOR与Hb有好的相关性（r＝－0．650，P＜0．05），轻中度贫血组sEPOR与 Hb相关性不明显（r＝0．135， P＜0．05）。结论 RA患者的外周血中存有高于健康对照组的sEPOR，并且可以与外周血中的EPO形成复合物。本研究对于RA机制的进一步研究和临床治疗具有重要意义。