红细胞生成素治疗前后肾性贫血患儿网织红细胞参数变化情况及临床意义

目的探讨红细胞生成素（EPO）治疗前后肾性贫血患儿网织红细胞参数变化情况及临床意义。方法采用Beckman coulter LH750全自动血液分析仪及Beckman LX20全自动生化分析仪，检测EPO治疗前65例慢性肾功能不全不同病期患儿和65名正常对照的红细胞（RBC）计数、血红蛋白（Hb）含量、网织红细胞百分比（Ret％）、网织红细胞不成熟度（IRF）和平均网织红细胞体积（MRV），同时检测其血清肌酐（Cr）和尿素氮（BUN）含量，并进行比较分析；比较EPO治疗前、后肾性贫血患儿Ret％、RBC、Hb、IRF、MRV等参数的变化。结果EPO治疗前，氮质血症组和肾功能衰竭组的Ret％较对照组均有升高，但IRF值基本正常或略低；经过EPO治疗后肾功能不全患儿的贫血状态明显得到改善，IRF值和MRV值明显升高，IRF值升高的程度比Ret％更加明显。结论Ret参数尤其是IRF值的检测，有助于了解肾性贫血患儿的骨髓增生程度和红系的生长情况。

The changes of reticulocyte indices of renal anemia children treated with erythropoietin and its clinical significance

Objective To study the changes of reticulocyte indices of renal anemia children who accepted the treatment with erythropoietin （EPO） and its clinical significance. Methods Red blood cell （RBC）, hemoglobin （Hb） and reticulocytes （Ret%）, immature retivulocyte fraction （IRF）, mean reticulocyte volumc （MRV） of peripheral blood were detected by Beckman coulter LH 750 hematology analyzer; creatinine （Cr） and blood urea nitrogen （BUN） were detected by Beckman LX20 biochemistry analyzer. The results were compared with 65 healthy controls and 65 chronic renal inadequacy patients. The results of Ret%, RBC, Hb, IRF and MRV of the renal inadequacy patients were compared before and after the treatment with EPO. Results The levels of Ret% of the patients with azotemia and the patients with renal failure increased in comparison with normal control before the treatment with EPO, but the levels of IRF were normal or lightly lower. There is obvious improvement in degree of renal anemia in the patients after treatement with EPO. The level of IRF and MRV of the patients with azotemia and the patients with renal failure increased. The change of IRF was more obvious than Ret%. Conclusions The detection of reticulocyte indices, especially the detection of IRF is favourable for observing the hyperplasia of bone marrow and the growth of erythrocyte. IRF is a specific indiex for evaluating the affect of the treatment with EPO.