老年人肾功能、贫血和促红细胞生成素的相关性研究 - 中华老年多器官 .doc

·老年人心肾疾病专栏· 老年人肾功能、贫血和促红细胞生成素的相关性研究 杨华昱, 顾 乡, 陈海平 （首都医科大学附属北京友谊医院医疗保健中心老年肾病组, 北京 100050(eGFR); 根据eGFR分为A组[eGFR＞50 ml/（min·1.73m2）]、B组[30 ml/（min·1.73m2）≤eGFR≤50 ml/（min·1.73m2）]和C组[eGFR＜30 ml/（min·1.73m2）]; 67例老年贫血患者再根据eGFR分为NA组、NB组和NC组（分组标准同上）。测定血红蛋白（Hb）、血肌酐（Scr）、EPO水平。结果 伴随着肾功能水平的降低, 老年人贫血患病率呈升高趋势, 并且A, B, C 3组之间比较均有显著性差异（P＜0.05）; 正常对照组Log EPO与Hb呈负相关（r2 = 0.219, P = 0.009）; A组Log EPO与Hb成负相关（r2 = 0.065, P = 0.045）, B组Log EPO与Hb之间无相关关系, C组Log EPO与Hb为正相关（r2 = 0.294, P = 0.006）; 老年贫血患者随着肾功能水平的降低EPO呈现下降趋势, NA组和NC组比较有显著性差异（P = 0.042）。结论 老年人肾功能水平中度减退时贫血患病率即显著增加; 随着年龄的增长, 老年人EPO的分泌代偿性增加, 但随着eGFR的不断下降, 这种代偿机制逐渐减弱; 当肾功能水平严重降低时, EPO分泌的减少是老年贫血发生的主要原因。 【关键词】 老年人; 肾小球滤过率; 贫血; 促红细胞生成素 【中图分类号】 R55; R692.5 【文献标识码】 A 【DOI】 10.3724/SP.J.1264.2011.00000 The correlation of renal function, anemia and erythropoietin in the elderly YANG Huayu, GU Xiang, CHEN Haiping (Division of Geriatric Nephrology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China) 【Abstract】 Objective To explore the correlative factors for anemia and the correlation of kidney function and anemia in the elderly through investigating the influence of glomerular filtration rate(GFR) and erythropoietin(EPO) on anemia incidence. Methods A total of 200 elderly patients(≥60 years) were enrolled and divided into three groups according to estimated GFR(eGFR) with Cockcroft-Gault equation: group A, eGFR＞50 ml/(min·1.73m2); group B, 30 ml/(min·1.73m2)≤eGFR≤50 ml/(min·1.73m2); group C, eGFR＜30 ml/(min·1.73m2). Besides, 30 healthy adults were selected as control group. In addition, 67 elderly patients with anemia were divided into NA, NB and NC group according to eGFR (the same as above standard). Hemoglobin(Hb), serum creatinine(Scr) and serum EPO were measured. Results Anemia incidence of the elderly increased with decline of renal function(P＜0.05). Log EPO was negatively correlated with Hb in control group(r2 = 0.219, P = 0.009) and group A(r2 = 0.065, P = 0.045), but positively