应用人基因重组红细胞生成素治疗尿毒症腹透患者贫血  

TREATMENT OF CAPD PATIENTS WITH RE-COMBINANT HUMAN ERYTHROPOIETIN

作　　者：丁小强[1] 廖履坦[1] 张凯[1] 汪克定 朱秀乔 徐元钊[1] 吴兆龙[1] 陶凤武[1] 

机构地区：[1]上海医科大学中山医院肾内科,杭州市红十字医院,苏州市第三医院,上海市杨浦区中心医院。

出　　处：《中华肾脏病杂志》1995年第1期10-12,共3页Chinese Journal of Nephrology

摘　　要：应用人基因重组红细胞生成素（ｒＨｕＥｐｏ）治疗１０６例尿毒症腹透患者贫血。治疗前Ｈｃｔ≤２５％。起始剂量１００Ｕ／Ｋｇ，每周３次。病例随机分为皮下和静脉治疗组。结果治疗后所有患者贫血均有明显纠正，２０周内９６．２％患者Ｈｃｔ≥３０％。维持剂量为１８７Ｕ．ｋｇ（－１）周。皮下组治疗早期Ｈｃｔ上升幅度显著高于静脉组，维持剂量亦显著低。缺铁、血浆ＰＴＨ明显升高和感染等降低ｒＨｕＥｐｏ疗效。治疗２０周血压升高和缺铁发病率分别为２８．３％和２３．３％。老年患者疗效稍差，易出现血压升高和缺铁。研究表明，ｒＨｕＥｐｏ能有效纠正尿毒症腹透患者贫血，皮下注射疗效较好，应密切随访血压和铁代谢等。06 CAPD patients with uncomplicated anemia re-ceived treatment of rHuEpo for 5 ￣ 24 months. Thepatients were divided randomly into subcutaneous ts.c) or intravenous (i. v.) group. The results showedthat anemia was ameliorated significantly in all patientsand Hct over 30/a0 in 96. 2/00 of patient within 20weeks. Erythrocyte transfusions were eliminated in allpatients. More than 50%～70% of patients experi-enced improved physical strength. appetite. sleep.einotion. family and social relationship. Comparedwith i. v. group, Hct increased more rapid in initialtreatment phase and the maintenance dose was lowersignifieantly in s. c. group. The factors contributed topoor responses of rHuEPo included iron deficiency,hyperparathyroidism, inflammation and chronic bleed-ing. The significant increase of platelet counts , red cellaggregation at both low and high shear rate and plasmafibrinogen concentration were found 3～5 months aftertreatment.The cardiac output, cardiac stroke volumeand cardiac index decreased while total peripheral resis-tance increased significantly in & patients 3￣5 momthsafter treatment. Adverse effects included increasedblood pressure (28. 3%), iron deficiency(23. 3%) ,hypertension crisis (0. 09%) , hyperpotassemia (4.9%) and flu-like symptom (1. 96%).

关 键 词：红细胞生成素 尿毒症 腹膜透析 贫血 

分 类 号：R556.905[医药卫生—血液循环系统疾病] R977.6[医药卫生—内科学]