重组人促红细胞生成素诱导的单纯红细胞再生障碍性贫血1例及文献复习  

Recombinant human erythropoietin induced pure red cell aplastic anemia: A case report and literature review

作　　者：张冬梅 王佳俊 杨菊 周万洪 ZHANG Dongmei;WANG Jiajun;YANG Ju;ZHOU Wanhong(Department of Nephrology,Tongnan County People's Hospital,Chongqing 402660,China)

机构地区：[1]重庆市潼南区人民医院肾脏内科,重庆402660

出　　处：《中国当代医药》2024年第23期165-168,共4页China Modern Medicine

摘　　要：随着生活水平的提高及寿命的延长,慢性肾脏病(CKD)的发病率越来越高,随着CKD的进展,其并发症逐步增多,肾性贫血是最常见的并发症之一,且随着病情加重,贫血也越来越严重。重组人促红细胞生成素(rhuEPO)是治疗肾性贫血的最常用药物,但rhuEPO可引起单纯红细胞再生障碍性贫血(PRCA)。rhuEPO诱导的PRCA临床上较为少见。本例为CKD 5期的患者,使用维持性血液透析,确诊初期贫血明显,经使用rhuEPO治疗后贫血好转,但后期在继续使用rhuEPO治疗过程中出现贫血加重。通过其临床资料、抗体检测及骨髓穿刺活检等,最终确诊为PRCA。本文通过对该病例进行报道并对PRCA相关知识进行回顾,以引起大家对类似疾病的重视。With the improvement of living standards and life expectancy,the incidence of chronic kidney disease(CKD)is increasing.With the progress of CKD,its complications are gradually increasing.Renal anemia is one of the most common complications,and with the aggravation of the disease,anemia is more and more serious.The recombinant human erythropoietin(rhuEPO)is the most commonly used drug in the treatment of renal anemia.However,rhuEPO can cause pure red cell aplastic anemia(PRCA).PRCA induced by rhuEPO is rare in clinical practice.This case was a patient with CKD stage 5,who used maintenance hemodialysis.The anemia was obvious in the early stage of diagnosis,and improved after treatment with rhuEPO,but the anemia worsened in the later stage of treatment with rhuEPO.Through its clinical data,antibody detection and bone marrow biopsy,eventually diagnosed with PRCA.This paper reports the case and reviews the related knowledge of PRCA,in order to attract people's attention to similar diseases.

关 键 词：慢性肾脏病 肾性贫血 重组人促红细胞生成素 单纯红细胞再生障碍性贫血 

分 类 号：R556.5[医药卫生—血液循环系统疾病] R692[医药卫生—内科学]