Vasko S D, Burdge J J, Ruberg R L, Verghese A S
Ohio State University Hospitals, Columbus 43210.
J Burn Care Rehabil. 1991 Sep-Oct;12(5):437-41. doi: 10.1097/00004630-199109000-00008.
Thermal injury is associated with an anemia of multifactorial etiology. Erythropoietin is a hormone that increases red blood cell production in response to tissue hypoxia and is now being produced in a recombinant form for treatment of some anemias. How erythropoietin levels change in response to thermal injury has not been adequately investigated to date. We studied 27 patients with burns of 10% to 85% total body surface area by serially measuring hemoglobin, hematocrit, reticulocyte count, and erythropoietin levels. Erythropoietin levels were determined by radioimmunoassay. Measurements were taken at admission, before surgery, and after surgery, or at least weekly for a period of up to 4 weeks. Twenty-five of the patients had a reticulocytopenic anemia by the end of the first postburn week. Twenty-three patients remained anemic throughout the study period. Erythropoietin levels increased appropriately as the patients became anemic. Erythropoietin levels related to hemoglobin in a logarithmic fashion with a correlation of -0.869. No differences were found on the basis of burn size or age. This study indicates that the anemia of thermal injury is associated with reticulocytopenia and an elevation of endogenous erythropoietin.
热损伤与多因素病因引起的贫血有关。促红细胞生成素是一种在组织缺氧时可增加红细胞生成的激素，目前已能以重组形式生产用于治疗某些贫血。迄今为止，促红细胞生成素水平在热损伤后如何变化尚未得到充分研究。我们通过连续测量血红蛋白、血细胞比容、网织红细胞计数和促红细胞生成素水平，对27例烧伤面积占体表面积10%至85%的患者进行了研究。促红细胞生成素水平通过放射免疫测定法确定。在入院时、手术前、手术后进行测量，或至少每周测量一次，持续长达4周。到烧伤后第一周结束时，25例患者出现网织红细胞减少性贫血。在整个研究期间，23例患者一直贫血。随着患者出现贫血，促红细胞生成素水平相应升高。促红细胞生成素水平与血红蛋白呈对数关系，相关性为-0.869。未发现烧伤面积或年龄方面的差异。这项研究表明，热损伤性贫血与网织红细胞减少和内源性促红细胞生成素升高有关。
