应用重组促红细胞生成素治疗长期血透患者的贫血

Clinical studies of recombinant human erythropoietin in patients on long-term dialysis

作者应用重组促红细胞生成素(rHuEPO)治疗68例依赖输血的透析患者(醋酸盐血透32例,碳酸氢盐血透24例,血液滤过12例)。治疗前 Hb 52.7±8.0g/L,Ht19.4±2.2%,血清铁蛋白>100μg/L。rHuEPO 治疗剂量150～300 u·kg^(-1)/周,静脉推注。当 Hb>100～120g/L,Ht>30%～35%时将 rHuEPO 减至维持量。疗程6.2±4.3个月。所有患者经 rHuEPO 治疗后不再输血,Hb 和 Ht 均有不同程度上升。其中39例 Hb 净增大于60g/L,Ht 增加大于10%,分别占治疗病例的57.4%。结果表明,rHuEPO 剂量为150～300 u·kg^(-1)/周是安全有效的,副作用远较国外报道为低。

Recombinant human erythropoietin(r-HuEPO),made in Amgen Inc,was administered in 68 dialyzed patients(32 on acetate hemodialysis,24 bicarbonate hemodialysis and 12 on hemofiltration). The mean initial Hb was 52.7±8.9 g/L,Ht 19.4±2.2%,serum ferritin 100 μg/L.Each patients received r-HuEPO intravenously at the dose of 300μ·kg^(-1)/week for 6.2±4.3 months.Target range of Hb was 100～120 g/L and Ht 30～35%.After r-HuEPO treatment,blood transfusion was not needed for any of the patients.Anemia was ameliorated with increase of Hb and Ht levels.It was found that the minimum effective dose of the r-HuEPO was 150～300μ·kg^(-1)/week.We conclude that r- HuEPO is effective as treatment for the anemia of dialyzed patients.However,hypertension,clotted dialyzers and dialysis access thromboses had been developed in some patients after correction of anemia.there is now a general consensus that these side effects may be minimized if r-HuEPO is initially given in small doses with increasement to avoid a too rapid correction of the anemia.