Goodnough L T, Price T H, Parvin C A
Department of Medicine and Pathology, Washington University School of Medicine, St. Louis, MO 63110, USA.
J Lab Clin Med. 1995 Jul;126(1):57-64.
The endogenous erythropoietin (EPO) response and the erythropoietic response to anemia in the elderly, as compared with that in younger subjects, is controversial. We therefore studied autologous blood donors undergoing aggressive phlebotomy to determine the effect of age and gender on the EPO response to blood loss anemia, along with the erythropoietic response to endogenous EPO and to exogenous recombinant human EPO therapy. Seventy-one patients underwent phlebotomy, up to 6 units over 3 weeks, and received either placebo (n = 18), EPO 150 U/kg (n = 16), EPO 300 U/kg (n = 18), or EPO 600 U/kg (n = 19) at each of the six visits. Linear regression analysis of the hemoglobin/log EPO relationship for 18 placebo patients revealed no differences in the endogenous EPO response to phlebotomy, as determined by the slopes and intercepts, for males versus females or as a function of age. We found no differences in endogenous EPO-stimulated red blood cell (RBC) volume expansion for males and females (7.06 +/- 2.4 and 7.22 +/- 2.2 ml/kg, respectively, p = 0.88) or as a function of age (estimated rate of change = -0.58 +/- 0.33 ml/kg for every 10 years of life, p = 0.10). Similarly, we found no differences in RBC response to EPO for males versus females (1.4 +/- 0.3 ml/kg vs 1.5 +/- 0.3 ml/kg per 1000 U/kg EPO, respectively, p = 0.80) or as a function of age (estimated rate of change = 0.051 +/- 0.15 ml/kg per 1000 U/kg EPO for every 10 years of life, p = 0.74).(ABSTRACT TRUNCATED AT 250 WORDS)
与年轻受试者相比，老年人内源性促红细胞生成素（EPO）反应以及对贫血的红细胞生成反应存在争议。因此，我们研究了接受积极放血的自体献血者，以确定年龄和性别对失血后贫血的EPO反应以及对内源性EPO和外源性重组人EPO治疗的红细胞生成反应的影响。71例患者接受放血，3周内放血多达6单位，在6次就诊时分别接受安慰剂（n = 18）、150 U/kg EPO（n = 16）、300 U/kg EPO（n = 18）或600 U/kg EPO（n = 19）。对18例安慰剂患者的血红蛋白/log EPO关系进行线性回归分析显示，根据斜率和截距确定，男性与女性对内源性EPO对放血的反应无差异，也与年龄无关。我们发现男性和女性内源性EPO刺激的红细胞（RBC）体积增加无差异（分别为7.06±2.4和7.22±2.2 ml/kg，p = 0.88），也与年龄无关（每增加10岁估计变化率=-0.58±0.33 ml/kg，p = 0.10）。同样，我们发现男性与女性对EPO的RBC反应无差异（每1000 U/kg EPO分别为1.4±0.3 ml/kg和1.5±0.3 ml/kg，p = 0.80），也与年龄无关（每增加10岁每1000 U/kg EPO估计变化率=0.051±0.15 ml/kg，p = 0.74）。（摘要截短至250字）
