Vogeser Michael, Schiel Xaver
Institute of Clinical Chemistry, Klinikum der Universität München-Grosshadern, Munich, Germany.
Clin Lab. 2002;48(11-12):595-8.
Serum erythropoietin (EPO) determination is useful in the diagnosis of renal anemia. In anemic patients with normal renal function increased EPO concentrations are typically found, however, so far hemoglobin-related reference ranges for serum EPO had not been established. In a cross-sectional manner we determined serum EPO in 280 patients with anemia and normal serum concentrations of creatinine and urea. Each 70 consecutive anemic patients with hemoglobin concentrations within four intervals were included (<8 g/dL; 8.1-9.0 g/dL; 9.1-10.0 g/dL; 10.1-11.0 g/dL). 97 patients were from surgical disciplines, 183 were from internal disciplines. Serum EPO was determined by use of an automated sandwich immunoassay that is standardized according to the WHO 2nd IRP 67/343. The ranges between the 20th and 80th percentile of EPO concentrations for the four specified hemoglobin intervals were as follows: Hb <8 g/dL, EPO 61.8-366 IU/L; Hb 8.1-9.0 g/dL, EPO 43.3-242 IU/L; Hb 9.1-10.0 g/dL, EPO 31.8-113 IU/L; Hb 10.1-11.0 g/dL, EPO 22.3-71.2 IU/L. Since no complete diagnostic evaluation of the patients' renal and respiratory functions was performed in this cross-sectional study we propose the 20th percentile of EPO concentrations as a preliminary hemoglobin-related reference range; serum EPO concentrations below this percentile speak for a contribution of EPO deficiency in the individual etiology of anemia.
血清促红细胞生成素（EPO）测定对肾性贫血的诊断很有用。然而，在肾功能正常的贫血患者中通常会发现促红细胞生成素浓度升高，到目前为止，尚未建立与血红蛋白相关的血清促红细胞生成素参考范围。我们采用横断面研究方法，对280例贫血且血清肌酐和尿素浓度正常的患者测定了血清促红细胞生成素。连续纳入每70例血红蛋白浓度处于四个区间的贫血患者（<8 g/dL；8.1 - 9.0 g/dL；9.1 - 10.0 g/dL；10.1 - 11.0 g/dL）。97例患者来自外科科室，183例来自内科科室。血清促红细胞生成素采用根据世界卫生组织第二国际参考制剂67/343标准化的自动化夹心免疫测定法进行测定。四个特定血红蛋白区间促红细胞生成素浓度第20百分位数至第80百分位数的范围如下：血红蛋白<8 g/dL，促红细胞生成素61.8 - 366 IU/L；血红蛋白8.1 - 9.0 g/dL，促红细胞生成素43.3 - 242 IU/L；血红蛋白9.1 - 10.0 g/dL，促红细胞生成素31.8 - 113 IU/L；血红蛋白10.1 - 11.0 g/dL，促红细胞生成素22.3 - 71.2 IU/L。由于在这项横断面研究中未对患者的肾脏和呼吸功能进行全面诊断评估，我们建议将促红细胞生成素浓度的第20百分位数作为与血红蛋白相关的初步参考范围；低于该百分位数的血清促红细胞生成素浓度表明促红细胞生成素缺乏在个体贫血病因中起作用。
