促红细胞生成素对慢性肾衰竭贫血患者骨髓祖细胞的影响

目的 观察促红细胞生成素(EPO)对慢性肾衰竭(CRF)贫血骨髓祖细胞的影响,探讨CRF血液系统改变及EPO治疗机制.方法 对20例CRF贫血采用国产济脉欣(EPO)3000～6000 U,皮下注射,每周3次,于治疗前及连续治疗12周后在髂后上棘同一部位行骨髓穿刺抽取等量骨髓液,观察EPO治疗前后血常规和骨髓祖细胞变化情况.结果 治疗后血红蛋白、血细胞比容、白细胞及血小板升高,而血清肌酐下降,与治疗前比较差异有统计学意义(P<0.01).骨髓红系造血祖细胞(CFU-E)、粒-单系祖细胞(CFU-GM)、成纤维祖细胞(CFU-F)集落数较治疗前均明显增多,差异均有统计学意义(P<0.01).骨髓CFU-F集落产率与CFU-E和CFU-GM集落产率呈正相关(r=0.32,r=0.49,P＜0.05).结论 EPO治疗CRF贫血可使骨髓造血微环境恢复,保护造血干细胞,并恢复其自我复制、增殖与分化.

Erythropoietin Influences Marrow Progenitor Cells in Chronic Kidney Failure (CRF) Patients

Objective To observe effects of erythropoietin（EPO） on marrow progenitor cells and the hematological system in chronic kidney failure（CRF） patients and to investigate mechanism of EPO-based therapy.Methods Subcutaneous injection of EPO（3000-6000 U,thrice per week） were given in 20 CRF patients.Draw marrow from posterosuperior iliac spine before therapy and 12 weeks after treatment.The changes in marrow progenitor cells and complete blood count were observed.Results After the treatment,hemoglobin,hematocrit,white blood cells and platelets increased creatinine in serum decreased;and there were significant differences（P0.01）.CFU-E,CFU-GM and CFU-F increased significantly after treatment（P0.01）.The settlement yield of CFU-F is olirect correlation with the settlement yield of CFU-E and CFU-GM（r=0.32,r=0.49,P0.05）.Conclusion Intradermal injection of EPO reestablishes the marrow hematopoietic microenvironment,protects hematopoietic stem cell to ecesis,restores self-replication and promotes differentiation.