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[慢性肾功能不全性贫血。II. 雄激素疗法对17例接受定期血液透析患者的疗效]

[Anemia of chronic renal insufficiency. II. Effect of androgen therapy in 17 subjects treated with periodic hemodialysis].

作者信息

Najean Y, Eberlin A, Delons S, Naret C, Petrover M, Aubert P

出版信息

Presse Med. 1983 Apr 23;12(18):1159-61.

PMID:6221284
Abstract

Seventeen patients with severe anaemia due to renal insufficiency treated by periodical haemodialysis received high parenteral doses (7 mg/kg/week) of androgens for a period of 10 months. Kinetic studies of erythroid stemcells (plasma clot method), erythropoiesis (radio-iron kinetics, bone marrow scintigraphy) and haemolysis (autologous and homologous red cell life span) were performed before and after treatment. Complete failure was observed in 6 patients, slight improvement in 4 and distinctly satisfactory results in 7. In three cases relapse was noted after treatment was discontinued. Clinical effectiveness was due to correction of the erythropoietic defect, without changes in the degree of haemolysis. Virilization was the only side-effect recorded. All subjects whose anaemia improved, even to a slight degree, felt much better. The following parameters were found to be predictive of androgen effectiveness: absence of bilateral nephrectomy, young age, and relatively slight erythropoietic deficiency. The clinical results were unrelated to the initial number of erythroid stem cells and to their increase under androgen therapy.

摘要

17例因肾功能不全导致严重贫血且接受定期血液透析的患者接受了大剂量肠外雄激素治疗(7毫克/千克/周),为期10个月。在治疗前后对红系干细胞进行了动力学研究(血浆凝块法)、红细胞生成(放射性铁动力学、骨髓闪烁扫描)以及溶血(自体和同源红细胞寿命)研究。6例患者治疗完全失败,4例稍有改善,7例效果明显令人满意。3例在停药后出现复发。临床疗效归因于红细胞生成缺陷的纠正,溶血程度无变化。记录到的唯一副作用是男性化。所有贫血有所改善的患者,即使只是稍有改善,感觉也好多了。发现以下参数可预测雄激素疗效:未行双侧肾切除术、年轻以及红细胞生成缺陷相对较轻。临床结果与红系干细胞的初始数量及其在雄激素治疗下的增加无关。

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