Goodnough L T
Case Western Reserve University, Cleveland, Ohio 44106.
Int J Cell Cloning. 1990 Jan;8 Suppl 1:203-10. doi: 10.1002/stem.5530080719.
For patients participating in autologous blood programs, one factor influencing the likelihood of homologous blood exposure is the number of available autologous units. To study the role of human recombinant erythropoietin (rhEpo) in increasing the amount of autologous blood that can be obtained prior to surgery, we conducted a randomized double-blind controlled trial of rhEpo in 47 adult patients scheduled for elective orthopedic procedures. Patients received either rhEpo (600 U/kg) or placebo i.v. twice weekly over a 21-day study period, during which up to six units of blood were collected. Patients were deferred from donation for hematocrit less than 34%. All patients received FeSO4, 325 mg orally three times daily. The mean number of units collected was 5.4 +/- 0.2 and 4.1 +/- 0.2 (mean +/- SE) for the rhEpo and placebo patients, respectively. Mean red blood cell volume donated by rhEpo patients was 41% greater than placebo patients (961 ml vs. 683 ml, p less than 0.05) Only one of 23 patients (4%) treated with rhEpo were unable to donate greater than or equal to 4 U, compared to seven of 24 (29%) placebo patients. No adverse effects were attributed to rhEpo. We conclude that rhEpo is efficacious in increasing autologous blood donated in elective surgical patients.
对于参与自体输血计划的患者，影响异体输血可能性的一个因素是可用的自体血单位数量。为了研究重组人促红细胞生成素（rhEpo）在增加术前可采集自体血量方面的作用，我们对47例计划进行择期骨科手术的成年患者进行了一项rhEpo的随机双盲对照试验。在为期21天的研究期间，患者每周两次静脉注射rhEpo（600 U/kg）或安慰剂，在此期间最多采集6个单位的血液。若血细胞比容低于34%，则患者延期献血。所有患者均口服硫酸亚铁，每日3次，每次325 mg。rhEpo组和安慰剂组患者采集的平均单位数分别为5.4±0.2和4.1±0.2（平均值±标准误）。rhEpo组患者捐献的平均红细胞体积比安慰剂组患者大41%（961 ml对683 ml，p<0.05）。接受rhEpo治疗的23例患者中只有1例（4%）无法捐献4个或更多单位的血液，而接受安慰剂治疗的24例患者中有7例（29%）无法达到这一标准。未发现rhEpo有不良反应。我们得出结论，rhEpo在增加择期手术患者的自体献血量方面是有效的。
