肾移植后贫血患者早期应用促红细胞生成素的临床效果分析

A retrospective study and value analysis of erythropoietin in improving postoperative anemia in renal transplant patients

目的研究肾移植后贫血患者早期应用促红细胞生成素(EPO)的效果。方法回顾性分析在苏州大学附属第一医院行肾移植手术的患者,其中术后使用促红细胞生成素治疗者为EPO组,未予以EPO治疗的为常规组。排除术后发生肾功能延迟恢复的受者,对余患者进一步统计分析,比较两组的一般资料、实验室资料和随访情况,观察药物不良反应。结果EPO组术后第2周血红蛋白(P=0.026)、红细胞计数(P=0.038)、血细胞比容(P=0.011)均高于常规组,且术后血肌酐水平较常规组更低(P=0.001)。自术后第1周,EPO组网织红细胞计数显著高于常规组(P<0.01)。分析血红蛋白与血肌酐的相关性,EPO组在术后第1周(r=-0.375,P=0.010)、第2周(r=-0.386,P=0.008)均呈负相关。用药期间,除6例患者出现一过性血钾升高,予对症处理后恢复正常,余未见明显药物不良反应。结论肾移植患者术后早期持续应用EPO,可明显改善肾移植患者的贫血状况,进一步促进移植肾功能的恢复。

Objective To explore the effects of early application of erythropoietin(EPO)in patients with anemia after renal transplantation.Methods Patients who underwent renal transplantation in the First Affiliated Hospital of Soochow University were retrospectively analyzed.According to whether EPO was applied after operation,the patients were divided into EPO group and routine group.Patients with delayed renal function recovery were excluded,and the remaining patients were further analyzed.The general,laboratory and follow-up data of the two groups were compared,and adverse drug reactions were observed.Results The hemoglobin(P=0.026),red blood cell count(P=0.038)and hematocrit(P=0.011)in EPO group were higher than those in the routine group 2 weeks after operation,while the postoperative serum creatinine level was lower(P=0.001).Since the first week after operation,the reticulocyte count in EPO group was significantly higher than that in routine group(P<0.01).There was a negative correlation between hemoglobin and serum creatinine in EPO group at week 1(r=-0.375,P=0.010)and week 2(r=-0.386,P=0.008).During the treatment,6 patients showed transient elevation of serum potassium,which returned to normal after symptomatic treatment,and no obvious adverse drug reactions were observed.Conclusion Continuous application of erythropoietin in the early stage after renal transplantation can significantly improve anemia in renal transplant patients and promote the recovery of renal function.