Salvati F, Troia C
Minerva Med. 1978 Nov 10;69(54):3719-23.
Anaemia is common in renal insufficiency and has various causes: 1) depressed marrow production of red cells, probably due to reduced production of erythropoietin, though the possibility of direct marrow inhibition on the part of uraemic toxins cannot be ruled out, together with iron deficiency, as occurs in prolonged dialysis management; 2) greater red cell destruction attributable to extraglobular factors and other mechanisms (microangiopathy, drugs, etc.); 3) greater blood loss following thrombocytopenia, reduced platelet adhesivity and agglutinability, dialysis. The main premisses on which the treatment of anaemia of uraemic patients is based are discussed.
贫血在肾功能不全患者中很常见，其病因多种多样：1）红细胞骨髓生成受抑制，可能是由于促红细胞生成素生成减少，不过尿毒症毒素直接抑制骨髓的可能性也不能排除，同时还存在缺铁情况，如在长期透析治疗中所见；2）由于球外因素和其他机制（微血管病变、药物等）导致红细胞破坏增加；3）血小板减少、血小板黏附性和凝集性降低以及透析后失血增多。本文讨论了尿毒症患者贫血治疗所依据的主要前提。
