基因重组人工促红细胞生成素对血液透析患者贫血的疗效观察

THE OBSERVATION OF THERAPY ANEMIA OF CHRONIC RENAL FAILURE WITLH RECOMBINANT HUMAN ERYTHROPOIETN

贫血是慢性肾衰的严重并发症之一，而使用基因重组人工促红细胞生成素（ｒ－ＨｕＥＰＯ）可迅速纠正贫血。大多数患者ｒ－ＨｕＥＰＯ治疗起始量为１００Ｕ／ｋｇ，每周３次静脉或皮下注射，６周后Ｈｂ可升至１００ｇ／Ｌ，红细胞压积（Ｈｃｔ）升至０．３３～０．３５以上，改用维持量５０Ｕ／ｋｇ，每周３次。其中４例患者需要增大剂量为１５０Ｕ／ｋｇ，每周３次。疗效较差的原因与反复肺感染、营养摄入不足、铁的缺乏有关。所以治疗中应补充铁、叶酸、ＶｉｔＢ＿（１２），对存在感染应积极控制。随着血红蛋白（Ｈｂ）及Ｈｃｔ上升，２／３病人出现高血压可通过药物控制；透析中易发生透析器及管路凝血，应增加肝素用量；易发生高钾血症，应做到充分透析。

nemia is one of the serious complications of chronic renal failure,therapy with recombinant hu-man erythropoietin(r-HuEPO)can correct such anemia officiently.For most patients,the initial doseof r-HuEPO is 100U/kg, by intravenously or subcutaneous, three time a week.After 6 weeks oftreatment, Hb could increase to 100g/L,and Hct to above 0.33～0.35.Then 500/kg 3 time a weekcan be used as maintaining dose. 4 patients need maintaining dose of 150U/kg,for pulmonary infec-tion,poor nutrition,and poor iron supply.Therefore, during the treatment,iron folie acid and VitB_(12) should be sapplied sufficiently and treat the infection effectively with the increasing of Hb and Hct,2/3 of the patients have hypertension which can be controled with medication. If there is thrombosis inthe dialyzer, the dose of heparin should be increased,The patients on r-HuEPO should be dialysisedsufficiently to prevent hyperkalemia.