Brown S, Caro J, Erslev A J, Murray T G
Am J Med. 1980 Feb;68(2):280-4. doi: 10.1016/0002-9343(80)90367-8.
An anephric patient undergoing hemodialysis experienced an increase in his hematocrit value (19 +/- 1 per cent to 31 +/- 1 per cent) as a result of increased erythropoiesis (reticulocyte count 1.8 per cent to 7.4 per cent). This increase occurred in concert with an elevation of the patient's liver enzyme levels and was maintained for four months. The hematocrit value returned to its base line only after the liver function tests showed improvement. During the period when the hematocrit value was increasing, the circulating level of erythropoietin was elavated to 71.0 mU/ml--a level higher than that seen in either anephric or nephric patients undergoing dialysis. When the hematocrit value and liver enzyme levels had returned to their base line values, the erythropoietin level was 4.3 mU/ml--a level in the range seen in anephric patients undergoing dialysis. The observations in this patient suggest that under certain circumstances, the liver can produce erythropoietin in the anephric patient; and, more importantly, that the bone marrow of at least some uremic patients is capable of responding to the endogenous erythropoietin.
一名接受血液透析的无肾患者，由于红细胞生成增加（网织红细胞计数从1.8%增至7.4%），其血细胞比容值有所上升（从19±1%升至31±1%）。这一上升与患者肝酶水平升高同时出现，并持续了四个月。仅在肝功能检查显示改善后，血细胞比容值才恢复至基线水平。在血细胞比容值上升期间，促红细胞生成素的循环水平升至71.0 mU/ml，这一水平高于接受透析的无肾或有肾患者。当血细胞比容值和肝酶水平恢复至基线值时，促红细胞生成素水平为4.3 mU/ml，这一水平处于接受透析的无肾患者的常见范围内。该患者的观察结果表明，在某些情况下，肝脏能够在无肾患者体内产生促红细胞生成素；更重要的是，至少部分尿毒症患者的骨髓能够对内源性促红细胞生成素产生反应。
