Kim Min-Jeong, Mayr Michael, Pechula Martina, Steiger Jürg, Dickenmann Michael
Division of Transplantation Immunology and Nephrology, University Hospital, Basel, Switzerland.
Transpl Int. 2006 Jan;19(1):12-8. doi: 10.1111/j.1432-2277.2005.00190.x.
The preliminary observation of marked erythrocyte microcytosis in patients treated with sirolimus (SRL) and mycophenolate mofetil (MMF) has been evaluated as part of a prospective study comparing SRL and cyclosporin A (CsA) as a primary immunosuppressant. Normal risk de novo kidney recipients were randomized either to SRL or to CsA. Additional immunosuppressants consisted of MMF and prednisone. In patients with erythrocyte microcytosis, iron deficiency was excluded by measuring serum ferritin and transferrin saturation rate. Fifty-nine patients (30 in SRL and 29 in CsA) were included. Mean corpuscular volume (MCV) (fl) on day 7 was 91.7 +/- 4.8 in SRL group versus 91.4 +/- 4.2 in CsA group (P = 0.77), whereas mean MCV on day 183 post-transplant was 78.5 +/- 3.8 in SRL group versus 88.4 +/- 3.4 in CsA group (P < 0.0001). Hemoglobin concentration (g/dl) was not significantly different. Only two patients in SRL group presented decreased transferrin saturation rate. Marked erythrocyte microcytosis without persistent anemia was observed in patients treated with SRL and MMF.
作为一项前瞻性研究的一部分，对接受西罗莫司（SRL）和霉酚酸酯（MMF）治疗的患者出现明显红细胞小红细胞症的初步观察进行了评估，该研究比较了SRL和环孢素A（CsA）作为主要免疫抑制剂的效果。低风险的初发肾移植受者被随机分为SRL组或CsA组。额外的免疫抑制剂包括MMF和泼尼松。对于出现红细胞小红细胞症的患者，通过测量血清铁蛋白和转铁蛋白饱和度来排除缺铁情况。共纳入59例患者（SRL组30例，CsA组29例）。SRL组第7天的平均红细胞体积（MCV）（飞升）为91.7±4.8，CsA组为91.4±4.2（P = 0.77），而移植后第183天SRL组的平均MCV为78.5±3.8，CsA组为88.4±3.4（P < 0.0001）。血红蛋白浓度（克/分升）无显著差异。SRL组只有两名患者的转铁蛋白饱和度降低。在接受SRL和MMF治疗的患者中观察到明显的红细胞小红细胞症但无持续性贫血。
