Levine E A, Gould S A, Rosen A L, Sehgal L R, Egrie J C, Sehgal H L, Levine H D, Moss G S
Department of Surgery, Michael Reese Hospital, Chicago, IL 60616.
Surgery. 1989 Aug;106(2):432-7; discussion 437-8.
The risks of transfusion-associated infectious disease have made increased efforts to avoid homologous transfusion imperative. Little attention has been focused on efforts to accelerate erythropoiesis as a method of reducing homologous blood use. Recombinant human erythropoietin (rHuEPO) has been shown to enhance erythropoiesis. The purpose of this study was to evaluate the effects of perioperative rHuEPO administration on postoperative erythropoiesis. Fifteen baboons were divided into three groups of five each. Group I received no rHuEPO. Group II received five daily preoperative doses of rHuEPO (1000 U/kg). Group III received five daily preoperative doses and 14 daily postoperative doses of rHuEPO (1000 U/kg). All animals underwent a laparotomy followed by an exchange transfusion to a final hematocrit of 15%. The time in days required to recover to hematocrits of 20% was significantly shorter in both groups that received preoperative doses of rHuEPO when compared with that of controls (3.3 vs 5.7 days, p less than 0.01). The recovery times to hematocrits of 25%, 30%, and baseline levels were all significantly shorter in the group that received both preoperative and postoperative doses of rHuEPO. The data show that perioperative dosage of rHuEPO significantly accelerates postoperative erythropoiesis. Perioperative administration of rHuEPO may reduce the requirements for homologous transfusion.
输血相关传染病的风险使得必须加大力度避免同种异体输血。作为减少同种异体血液使用的一种方法，加速红细胞生成的努力却很少受到关注。重组人促红细胞生成素（rHuEPO）已被证明可增强红细胞生成。本研究的目的是评估围手术期给予rHuEPO对术后红细胞生成的影响。15只狒狒被分为三组，每组五只。第一组未接受rHuEPO。第二组在术前每天接受五次rHuEPO剂量（1000 U/kg）。第三组在术前每天接受五次剂量，并在术后每天接受14次rHuEPO剂量（1000 U/kg）。所有动物均接受剖腹手术，随后进行换血，使最终血细胞比容达到15%。与对照组相比，术前接受rHuEPO剂量的两组恢复到血细胞比容20%所需的天数明显更短（3.3天对5.7天，p小于0.01）。术前和术后均接受rHuEPO剂量的组恢复到血细胞比容25%、30%和基线水平的时间均明显更短。数据表明，围手术期给予rHuEPO可显著加速术后红细胞生成。围手术期给予rHuEPO可能会减少同种异体输血的需求。
