大剂量rHuEPO对慢性肾衰竭贫血患者骨髓象及铁代谢的影响  

Influence of high dose of rHuEPO for renal anemian on bone marrow and iron metabolism

作　　者：肖青[1] 魏晓菲[2] 郭振涛[1] 李香玲[1] 王金铃[1] 陈静[1] 

机构地区：[1]潍坊医学院附属医院,山东潍坊261031 [2]北京大学第九临床医学院内科

出　　处：《山东医药》2008年第8期9-11,共3页Shandong Medical Journal

摘　　要：目的探讨大剂量重组人促红细胞生成素(rHuEPO)治疗慢性肾衰竭(CRF)贫血的效果及机制。方法对60例CRF贫血患者予rHuEPO 1·2万IU皮下注射,1次/周,连续8周,检测血清转铁蛋白受体(sTfR)浓度变化,骨髓穿刺行骨髓显微图像分析和铁染色,观察血象、骨髓象变化,比较治疗前后血清铁蛋白(SF)、血清铁(SI)及铁粒幼细胞计数并判定疗效。对总红系所占百分数(E)与SI、SF、红细胞压积(Hct)行相关分析。结果网织红细胞计数(Ret)于治疗1周后开始升高;RBC、血红蛋白(Hb)、Hct于治疗2周后开始升高,8周时显著高于用药前(P<0·01);骨髓红系增生明显活跃,各类幼红细胞比率及E均显著升高(P<0·01),其中以晚幼红增生最为明显。sTfR显著增高,SI、SF及铁粒幼细胞计数均明显降低。相关分析示E与SI、Hct呈正相关,与铁粒幼细胞计数呈负相关,Hct与SF呈负相关。结论rHuEPO治疗CRF贫血疗效显著;其机理可能为刺激骨髓造血,使机体储存铁被利用。Objective To study the effect of high dose of rHuEPO for renal anemian on bone marrow and iron metabolism. Methods 60 patients with renal anemia received treatment of high dose of rHuEPO injection subcutaneous for 8 weeks, bone marrow aepiration was performed within the first day of admissiun and repeated 8 weeks later, observe the variation of erythro percent, sideroblast counts, RBC, Hb, Hct, Ret count, serum ferritin and serum iron before and after the therapy. Results After the therapy, the E, RBC, Hb, Hct and Ret count increased significantly（ P 〈 0.01, bone marrow iron deposits decreased progressively as Hct increased. Conclusion rHuEPO is effective in treatment of renal anemia, with the expansion of the red cell mass, a great lot of deposited iron was utilized.

关 键 词：重组人促红细胞生成素 肾性贫血 骨髓象 铁代谢 

分 类 号：R692.5[医药卫生—泌尿科学]