肾移植后红细胞增多症的药物治疗

Medical therapy of post-transplant erythrocytosis

肾移植后红细胞增多症（ＰＴＥ）是肾移植后一种较为常见的并发症，为探讨其治疗方法，分别以氨茶碱、地尔硫、依那普利来治疗ＰＴＥ患者。发现氨茶碱能明显降低ＰＴＥ患者的血红蛋白（Ｈｂ）及红细胞压积（ＨＣＴ），该作用与促红细胞生成素降低有关，其缺点是停用后可复发，但继续服用仍有效。依那普利不但能显著降低Ｈｂ及ＨＣＴ，还可治疗难治性高血压，适用于伴有高血压的ＰＴＥ患者；地尔硫对ＰＴＥ的治疗作用不大。认为ＰＴＥ虽属自限性疾病，但恰当的药物治疗是必需的。

Post-transplant erythrocytosis (PTE) is a common complication of renal transplantation. Aminophyllini, diltiazemi, and enalapril were separately used to treat PTE. It was found that aminophyllini could largely lower Hb and HCT by reducing the secretion of EPO of the PTE patients. The shortcoming for aminophyllini was relapse of EPO after intermination of the drug, but repeated administration was still effective. Enalapril not only greatly lowered Hb and HCT, but also treated refractory hypertension, so it was used to treat PTE patients associated with hypertension. It is considered that appropriate medical therapy is necessary for PTE. 