红细胞生成素治疗尿毒症血液透析患者贫血的疗效

目的　观察重组人红细胞生成素 (rHuEPO)治疗尿毒症血液透析贫血患者的疗效及不良反应。　方法　 2 8例慢性维持性血液透析患者应用rHuEPO治疗 4周、8周及 12周后 ,观察其血红蛋白、红细胞数、红细胞比容、血清铁蛋白及血液流变学指标的变化。　结果　患者血红蛋白、红细胞数及红细胞比容均明显增高 ;全血高切、低切粘度均随着治疗时间延长而逐渐增高 ,在治疗 4周、8周及 12周时相比差异显著 (依次P <0 .0 5、P <0 .0 1和P <0 .0 0 1) ;血浆粘度及纤维蛋白原无显著改变 (P >0 .0 5 ) ;红细胞聚集指数有升高趋势 ,与治疗前比有显著意义 (P <0 .0 5 ) ;有 12例出现血压升高 ,1例发生动静脉内瘘管阻塞。　结论　rHuEPO使用有助于改善血液透析患者贫血 ,但同时需注意其血粘度和血压升高的不良反应

Therapeutic effect of recombinant human erythropoietin on anemia of patients with uremia in maintenance hemodialysis

Objective To evaluate the therapeutic effect of recombinant human erythropoietin (rHuEPO) on anemia of patients with uremia in maintenance hemodialysis. Methods Hemoglobin (Hb),erythrocyte(RBC),hematocrit(Hct),serum ferritin(SF), and blood rheology were measured in 28 patients with maintenance hemodialysis after 4,8 and 12 weeks of rHuEPO therapy, respectively.Results Hb,RBC and Hct were increased significantly with the therapy of rHuEPO.Whole blood viscosity and low shear viscosity were increased significantly after 4,8 and 12 weeks of rHuEPO therapy.RBC aggregation index had a tendency of elevation,but plasma viseosity and plasma fibrinogen had no significant increase after treatment with rHuFPO.Blood pressure of 12 patients were increased, and one patient had obstruction of arteriovenous fistula. Conclusion rHuEPO may contribut to improvement of uremic renal anemia,but the elevation of whole blood viscosity and hypertension should be attended.