大剂量促红细胞生成素治疗肾性贫血

目的观察大剂量促红细胞生成素治疗肾性贫血的临床疗效及其在尿毒症血透患者体内的代谢。方法尿毒症贫血血透患者28例,随机分为2组,观察组给予大剂量促红细胞生成素、多糖铁复合物和高通量血透,对照组给予常规剂量促红细胞生成素、右旋糖酐铁和低通量血透。两组均于治疗16周后观察相关贫血和生化指标及血清促红细胞生成素浓度变化。结果观察组血红蛋白、红细胞压积、血清铁蛋白、转铁蛋白饱和度升高均较对照组明显(P<0.05)。两组血清促红细胞生成素浓度均较治疗前升高(P<0.05),大剂量促红细胞生成素注射7d内各项血清指标浓度稳定,注射16周后各项指标无进一步改变。结论大剂量促红细胞生成素联合多糖铁复合物和高通量透析能更有效的改善尿毒症血透患者的缺铁和贫血,且大剂量促红细胞生成素长间隔治疗可使血清促红细胞生成素水平维持稳定。

Observation on therapeutic effect of high-dose erythropoietin for renal anemia ZHANG Ming,

Objective To observe the efficacy of high-dose erythropoietin(EPO) for treatmen of renal anemia, study the metabolism of high-dose EPO in uremic hemodialysis patients.Method The 28 uremic hemodialysis patients were randomized into observation group and control group(14 in each group).Observation group received high-dose EPO, polysaccharide-iron complex and high-permeability dialysis;control group received routine dose EPO, iron dextran and low-permeability dialysis.All the patients were treated for 16 weeks.Correlated anemic and biochemical indicators were detected.Changes of serum EPO levels were observed.Result After treatment, the levels of serum hemoglobin(Hb), hematocrit(HCT), serum ferritin(SF)and transferrin saturation(TS)in observation group were higher than those in control group(P <0.05).Serum EPO levels in both groups were significantly increased after treatment(P<0.05).Serum EPO level was stable within 7 days after injection of high dose EPO, it had no additional increase after treatment for 16 weeks.Conclusion Treatment with high-dose erythropoietin, polysaccharide-iron complex and high-permeability dialysis can improve iron deficiency and anemia more efficiently in uremic hemodialysis patients.Serum EPO level is stable during the treatment with highdose EPO at long intervals.