Zappacosta A R, Perras S T, Bell A
Bryn Mawr Hospital, Pennsylvania.
Am J Med. 1991 Sep;91(3):229-32. doi: 10.1016/0002-9343(91)90120-m.
The purpose of this study was to analyze data retrospectively from our use of weekly subcutaneous recombinant human erythropoietin (rHuEPO) in predialysis and peritoneal dialysis patients with anemia.
All anemic patients with progressive renal failure (12 predialysis and seven home peritoneal dialysis) in whom subcutaneous rHuEPO therapy was begun at, or was reduced to, a weekly dose were studied retrospectively. Patients were not selected for, nor excluded from, these observations for any other reason. Hematocrit and endogenous creatinine clearance were monitored regularly, and no other new treatment for anemia was given except oral iron. Iron-deficiency anemia was considered improbable because of normal red blood cell mean corpuscular volume. Unfortunately, iron parameters were not monitored.
The hematocrit increased 4 to 9 percentage points in 4 to 13 weeks in all but two patients who were initially treated with weekly doses, and a hematocrit of 31% was achieved in these patients within 6 to 12 weeks. The mean effective dose to accomplish this was 150 U/kg. All but three patients could be maintained on weekly doses at a hematocrit of 31% or higher. The mean effective dose was 75 U/kg.
It is concluded that subcutaneous rHuEPO administered weekly can correct the anemia of predialysis and peritoneal dialysis patients. Weekly dosing is more convenient for patients and may be less costly for Medicare providers.
本研究旨在回顾性分析我们在贫血的透析前及腹膜透析患者中使用每周一次皮下注射重组人促红细胞生成素（rHuEPO）的数据。
对所有开始皮下注射rHuEPO治疗或减至每周一次剂量的进行性肾衰竭贫血患者（12例透析前患者和7例家庭腹膜透析患者）进行回顾性研究。这些观察对象未因任何其他原因被入选或排除。定期监测血细胞比容和内生肌酐清除率，除口服铁剂外，未给予其他新的贫血治疗方法。由于红细胞平均体积正常，缺铁性贫血被认为不太可能。遗憾的是，未监测铁参数。
除两名最初接受每周一次剂量治疗的患者外，所有患者的血细胞比容在4至13周内升高了4至9个百分点，这些患者在6至12周内血细胞比容达到31%。实现这一目标的平均有效剂量为150 U/kg。除三名患者外，所有患者均可维持每周一次剂量，血细胞比容达到31%或更高。平均有效剂量为75 U/kg。
得出的结论是，每周皮下注射rHuEPO可纠正透析前及腹膜透析患者的贫血。每周给药对患者更方便，对医疗保险机构来说成本可能更低。
