大剂量重组人促红细胞生成素治疗慢性肾衰竭贫血的效果及机制

目的：研究和探讨大剂量重组人促红细胞生成素用于慢性肾衰竭（CRF）贫血的临床治疗效果及治疗机制。方法：选取本院2012年3月-2014年3月收治的慢性肾衰竭贫血患者58例，所有患者均予以1.2万IU rHuEPO皮下注射，每周1次，共治疗8周。患者每日服用维铁缓释片1粒，并常规运用维生素B12和叶酸。检测患者的骨髓象、血象、SI、SF及铁粒幼细胞计数。结果：58例患者中显效28例，有效26例，无效4例，总有效率为93.1%。用药2周后患者的Ret、RBC、Hb、Hct开始升高，用药8周后血象红系各指标较用药前有显著升高，差异均有统计学意义（P〈0.01）。患者骨髓红系增生较治疗前而言活跃显著，且早幼红、中幼红、晚幼红和E值较用药前有显著升高，其中晚幼红增生最显著，故G/E值较用药前显著降低，经治疗8周后患者SI、SF及铁粒幼细胞值均显著降低，差异均有统计学意义（P〈0.05）。结论：大剂量重组人促红细胞生成素可有效用于慢性肾衰竭贫血患者的临床治疗，通过刺激骨髓造血的机理恢复机体的正常造血功能，在慢性肾衰竭贫血患者的临床治疗上具有广泛的发展前景。

The Effect and Mechanism of Large Dose of Recombinant Human Erythropoietin in the Treatment of Anemia of Chronic Renal Failure

Objective：To investigate the clinical effect and therapeutic mechanism of large dose of recombinant human erythropoietin in the treatment of anemia of chronic renal failure（CRF）.Method：58 patients with chronic renal failure anemia in our hospital from March 2012 to March 2014 were selected,all patients were treated with 12 000 IU rHuEPO subcutaneous injection,1 times a week,for 8 weeks.The patients were daily taken Ferrous Sulfate and Vitamin Complex Sustained-release Tablets 1 grains and regularly used vitamin B12 and folic acid.The patients’s bone marrow, blood,SI,SF and sideroblast count were detected.Result：In 58 patients,28 cases were markedly effective,26 cases were effective,4 cases were invalid,the total effective rate was 93.1%.After 2 weeks of treatment,Ret,RBC,Hb, Hct in patients began to increase,after 8 weeks of treatment,blood red line increased significantly compared with those before treatment,the differences were statistically significant（P〈0.01）.Red blood hyperplasia of bone marrow in patients with active significantly than before treatment,and early normoblast,young red,late erythroblasts and E value were significantly higher than those of before treatment,the late erythroid hyperplasia significantly,the G/E value decreased significantly compared with those before treatment,after treatment for 8 weeks in patients with SI,SF and iron bead young cells were significantly reduced,the differences were statistically significant（P〈0.05）.Conclusion：Large dose of recombinant human erythropoietin can be effectively used for the clinical treatment of patients with anemia in chronic renal failure,restore the body through a mechanism to stimulate bone marrow of normal hematopoietic function,it has broad prospects in the clinical treatment of patients with anemia in chronic renal failure..