大剂量重组人促红细胞生成素对肾性贫血患者骨髓象及铁代谢的研究

目的观察应用大剂量重组人促红细胞生成素(rHuEPO)治疗肾性贫血时患者的骨髓象在治疗前后的变化,探讨rHuEPO对肾性贫血患者骨髓和铁代谢的影响。方法对35例肾性贫血患者给予1万IU rHuEPO皮下注射,每周1次,连续4周,在治疗前后分别行骨髓显微成像分析和铁染色;分别检测血象中RBC, Hb,Hct,Ret%;检测血清铁,SF和骨髓像中E%,G/E,外铁、铁粒幼细胞并进行自身对照。结果35例中显效10 例、有效7例,总有效率48.57%.22例治疗后红系骨髓象增生活跃程度比治疗前明显增强(P<0.01),且增幅高于红系血象各项指标,而血清铁、SF、外铁、铁粒幼细胞均显著降低。结论rHuEPO治疗肾性贫血疗效显著,骨髓红系增生显著,随着骨髓造血增强,大量机体储存铁被利用。

The Effect of High Dose of rHuEPO for Renal Anemian on Bone Marrow and Iron Metabolism

Objective To study the effect of high dose of rHuEPO for renal anemian on bone marrow and iron metabolism . Methods Thirty-five patients with renal anemia received treatment of high dose of rHuEPO injection subcutaneous for 4 weeks, bone marrow aepiration was performed within the first day of admission and repeated 4 weeks later, observe the variation of erythro percent, sideroblast counts, RBC, Hb, Hct, Ret count, serum ferritin and serurn iron before and after the therapy. Results After the therapy, the E% , RBC, Hb, Hct and Ret count increased significantly, bone marrow iron deposits decreased progressively as Hct increased. Conclusion rHuEPO is effective in treatment of renal anemia, with the expansion of the red cell mass, a great lot of deposited iron was utilized.