人基因重组红细胞生成素皮下和静脉用药对尿毒症贫血的疗效比较

Comparison between subcutancous and intravenous injections on effects of recombinant human erythropoietin in uremic anemia

应用人基因重组红细胞生成素治疗１３８例尿毒症透析病人，随机分组比较ｓｃ和ｉｖ对贫血的疗效。起始剂量１００Ｕ·ｋｇ－１，ｔｉｗ，待血细胞比容（旧称红细胞压积）（ＨＣＴ）≥０．３０后减量，维持ＨＣＴ０．３０－０．３５。治疗２ｗｋＨＣＴ显著升高（Ｐ＜０．０１），２０ｗｋ内９６．４％病人ＨＣＴ≥０．３０。ｓｃ组治疗早期ＨＣＴ上升快、维持剂量低（均Ｐ＜０．０５）。表明本药治疗尿毒症贫血以ｓｃ更为有效和方便。

To compare the effects of recombinant human erythropoietin(rHuEPO)on uremic anemia between subcutaneous and intravenous administrations prospectively,138uremic patients(M 71,F 67;age 40±s 12a)with uncomplicated anemia were assigned randomly to receive rHuEPO by sc and iv.The initial dose was 100 U·kg-1,3 times per week. The target hematocrit(HCT)was 0.30-0.35.Before treatment, HCT of all patients was below 0.25(0.18±0.05).The results showed that HCT increased significantly 2 wk aftertreatment and increased to 0.30 or more in 96.4% of patients within 20 wk.In peritoneal dialysis sc and iv group, hemodialysis sc and iv groups, the increase rates of HCT(100-1·wk-1)in acute treatment phase were 1.54± 0.26 and 1.31± 0.28(P<0.01),0.98± 0.26 and 0.82±0.28( P<0.01),respectively;while the maintenance doses(U·kg-1·wk-1)were 171±49and 194±24(P<0.05),202± 36 and 231±52(P<0.01),respectively.No severe adverse effect was observed.It is concluded that rHuEPO is effective in correcting uremic anemia and sc is a more appropriate administration route than iv.