Эффект диализатора с витамином Е на лечение анемии и уровень воспаления


DOI: https://dx.doi.org/10.18565/nephrology.2018.3.41-46

Е.В. Шутов, О.В. Балкарова, Г.В. Котлярова

1 ГБУЗ «Городская клиническая больница им. С.П. Боткина ДЗМ»; Москва, Россия; 2 ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФ; Москва, Россия; 3 ГБУЗ «Городская клиническая больница № 24 ДЗМ»; Москва, Россия
Цель исследования. Несмотря на успехи гемодиализной терапии, одной из нерешенных остается проблема биосовместимости диализных мембран, которая приводит к ухудшению результатов лечения, а также способствует развитию резистентности к эритропоэтин-стимулирующим препаратам при лечении анемии.
Материал и методы. В открытое проспективное исследование по изучению влияния диализных мембран, покрытых витамином Е, на уровень воспаления и индекс резистентности к эритропоэтин-стимулирующим препаратам (ИРЭ) в течение 3 месяцев были включены 30 пациентов, получавших гемодиализ не менее 3 месяцев. Определялись ежемесячно: уровень интерлейкина-6 (ИЛ-6), С-реактивного белка, показатели обмена железа, альбумин, преальбумин.
Результаты. За время лечения больных с применением полисульфоновых диализных мембран, покрытых витамином Е, статистически значимо снизился уровень ИЛ-6 – с 9,4±13,5 до 1,3±2,1 пг/мл (p<0,001). Показатели обмена железа, альбумина, преальбумина и С-реактивного белка достоверно не изменились. ИРЭ в целом по группе достоверно не изменился, однако у пациентов с исходно высоким ИРЭ он снизился с 12,5±2,2 до 10,7±1,2 МЕ/кг/нед/г (р<0,05).
Выводы. Применение полисульфоновых диализных мембран, покрытых витамином Е, целесообразно использовать больным с высоким ИРЭ для лечения анемии и снижения уровня воспаления.
Ключевые слова: анемия, гемодиализ, воспаление, витамин Е
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Об авторах / Для корреспонденции

Шутов Е.В. – д.м.н., зав. отделением нефрологии № 12 ГБУЗ «ГКБ им. С.П. Боткина ДЗМ» , профессор кафедры нефрологии и гемодиализа ФГБОУ ДПО РМАПО; Москва, Россия. E-mail: shutov_e_v@mail.ru
Балкарова О.В. – зав. отделением гемодиализа ГБУЗ «ГКБ № 24 ДЗМ»; Москва, Россия.
Котлярова Г.В. – к.м.н., врач-нефролог ГБУЗ «ГКБ им. С.П. Боткина ДЗМ»; Москва, Россия.

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