消化道肿瘤贫血患者促红细胞生成素与贫血治疗方案的关系

Relationship of Therapeutic Regimen and Erythropoietin in Patients with Gastrointestinal Cancer-related Anemia

目的分析消化道肿瘤患者内源性促红细胞生成素水平及贫血状态,探讨使用重组人促红细胞生成素治疗消化道肿瘤相关性贫血的方案.方法内源性促红细胞生成素采用Elisa检测,血红蛋白采用常规检测.消化道肿瘤非贫血患者为对照组,消化道肿瘤贫血患者组为观察组.结果统计发现男女之间的贫血率没有差异,消化道肿瘤相关性贫血患者占38.95%,其中以胃癌居首,占42.2%,食管鳞癌最低,占35.6%.消化道肿瘤患者在化疗前贫血比非贫血患者EPO高而Hb低,两者存在逆相关关系,化疗后贫血患者Hb继续降低,EPO上升;而在化疗后非贫血患者中出现的26例贫血患者,其中16例出现EPO急剧上升,10例EPO几乎不变,EPO存在极显著差异,具有统计学意义,而Hb没有明显的差异.结论消化道肿瘤相关性贫血发生率较高,在临床治疗中要密切关注.

Objective To analyze the endogenous erythropoietin（ EPO） level and the anemia in patients with gastrointestinal tumors and study the therapeutic regimen with the recombinant human EPO（ rhEPO） for the treatment of gastrointestinal cancer-related anemia. Methods The endogenous EPO was detected with Elisa,and hemoglobin（Hb） was measured with the conventional method. Results The results revealed that there was no difference in the anemia rate between females and males,patients with gastrointestinal cancer accounted for 38.95%,of which gastric cancer ranked the first,accounting for 42. 2%,and that of esophageal cancer-related anemia was the lowest,accounting for 35. 6%. The EPO level of patients with gastrointestinal cancer-related anemia was higher than that of non-anemia patients before the chemotherapy,but the Hb level was lower,presenting a inverse linear relation between the both;the Hb level of patients with the anemia dropped further and the EPO level increased after the chemotherapy. In the patients with gastrointestinal cancer but without anemia,26 cases of them turned up anemia after the chemotherapy,16 cases of them showed a sharp increase in the EPO level,and 10 cases of them did not show an obvious difference in the EPO level,suggesting that there was a significant difference in EPO and no significant difference in Hb. Conclusion The incidence of gastrointestinalcancer-related anemia is high and a close attention should be paid to it in clinic.