Kickler T S, Spivak J L
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.
JAMA. 1988 Jul 1;260(1):65-7.
The effect of repeated phlebotomy on serum immunoreactive erythropoietin levels was studied prospectively in 69 autologous blood donors. At the time of the initial phlebotomy, 11 men (33%) and two women (6%) were anemic; during the course of blood donations, anemia (defined as a hematocrit less than 0.41 for men and less than 0.36 for women) developed in an additional 17 men (71%) and 14 women (45%). Although there was an increase in the level of serum immunoreactive erythropoietin with successive phlebotomies, the increase was not substantially out of the normal range. The lack of an erythropoietic response to repeated phlebotomies in association with the small increment in the serum erythropoietin level was not due to iron deficiency, since the level of red-cell free protoporphyrin did not increase in these patients. We conclude that within the hematocrit range permissible for autologous blood donation, the degree of anemia experienced is insufficient to initiate an adequate increase in erythropoietin production; as a consequence, mild anemia develops in a majority of donors, and the volume of blood donated is inadequate to meet their operative needs.
对69名自体献血者进行前瞻性研究，以探讨重复放血对血清免疫反应性促红细胞生成素水平的影响。初次放血时，11名男性（33%）和2名女性（6%）贫血；在献血过程中，另外17名男性（71%）和14名女性（45%）出现贫血（定义为男性血细胞比容低于0.41，女性低于0.36）。尽管随着连续放血，血清免疫反应性促红细胞生成素水平有所升高，但升高幅度并未显著超出正常范围。与血清促红细胞生成素水平的小幅升高相关的是，重复放血后缺乏促红细胞生成反应并非由于缺铁，因为这些患者的红细胞游离原卟啉水平并未升高。我们得出结论，在自体献血允许的血细胞比容范围内，所经历的贫血程度不足以引发促红细胞生成素产量的充分增加；因此，大多数献血者会出现轻度贫血，且所捐献的血量不足以满足其手术需求。
