McMahon L P, Dawborn J K
Department of Medicine, Austin Hospital, Heidelberg, Victoria.
Am J Nephrol. 1990;10(5):404-8. doi: 10.1159/000168156.
Twelve stable haemodialysis patients were divided into two groups and given recombinant human erythropoietin (r-HuEPO) for 14 weeks either intravenously (i.v.) or subcutaneously (s.c.). Dosage was 25 units/kg either thrice (i.v.) or twice (s.c.) per week for 7 weeks, and then 50 units/kg for a further 7 weeks. Response to s.c. therapy was comparable to i.v. despite a 33% lower weekly dosage, and was significant at both 7 (i.v.: 1.1 +/- 0.3, mean +/- SEM, p = 0.02; s.c.: 0.8 +/- 0.3 g/dl, p = 0.03) and 14 weeks (i.v.: 2.8 +/- 0.5, p = 0.003; s.c.: 2.6 +/- 0.6 g/dl, p = 0.009). A correlation was observed between response to r-HuEPO and initial ferritin levels (r = 0.63, p = 0.04). One patient required an increase in antihypertensive medication and there was one arteriovenous fistula thrombosis. Results suggest that overall s.c. therapy is as effective as i.v. therapy, and that a good response with few side effects can be obtained using relatively low doses of r-HuEPO.
12名稳定的血液透析患者被分为两组，分别接受静脉注射（i.v.）或皮下注射（s.c.）重组人促红细胞生成素（r-HuEPO）治疗14周。剂量为每周25单位/千克，静脉注射组每周三次，皮下注射组每周两次，持续7周，然后在接下来的7周内剂量增加至50单位/千克。尽管皮下注射组每周剂量低33%，但其治疗反应与静脉注射组相当，在7周（静脉注射组：1.1±0.3，平均值±标准误，p = 0.02；皮下注射组：0.8±0.3 g/dl，p = 0.03）和14周时（静脉注射组：2.8±0.5，p = 0.003；皮下注射组：2.6±0.6 g/dl，p = 0.009）均有显著差异。观察到对r-HuEPO的反应与初始铁蛋白水平之间存在相关性（r = 0.63，p = 0.04）。1名患者需要增加抗高血压药物剂量，发生了1例动静脉内瘘血栓形成。结果表明，总体而言，皮下注射治疗与静脉注射治疗效果相同，使用相对低剂量的r-HuEPO即可获得良好反应且副作用较少。
