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有两个较重要的因素影响终末期肾病(ESRD)性贫血的发病机理,首要的是促红细胞生成素(EP)的产生,次要的为聚胺(polyamines)。聚胺是一种有机阳离子,为正常细胞的增殖和分化起各种作用,它蓄积于ESRD患者的血浆和体液中,可减少红细胞的增殖和成熟。它对此种贫血的作用有三个主要争论。第一种争论要点在于ESRD患者的血浆和体液中是否有聚胺蓄积。几项研究证明,尿毒症时聚胺水平升高。有些研究发现精胺和精眯水平未增加。Sstio等人的报告表明血清聚胺水平在ESRD升高,且贫血与尿毒症患者中某些聚胺水平之间有关。第二种争论要点在于聚胺水平升高对红系生成是否发挥特殊抑制作用。由于正色素正细胞性贫血ESRD
Two of the more important factors affect the pathogenesis of ESRD anemia, primarily erythropoietin (EP) production, and secondary, polyamines. Polyamines are organic cations that play a variety of roles in the proliferation and differentiation of normal cells. They accumulate in the plasma and body fluids of ESRD patients and reduce the proliferation and maturation of erythrocytes. It has three major debates about the role of anemia. The first argument is whether polyamines accumulate in the plasma and body fluids of ESRD patients. Several studies have shown that uremia increased levels of polyamine. Some studies found no increase in spermine and spine levels. Sstio et al reported that serum polyamine levels increased at ESRD and that anemia was associated with certain levels of polyamines in uremic patients. The second argument is whether polyamine levels have a specific inhibitory effect on erythroid generation. Due to nocturnate ESRD