Spivak J L
Division of Hematology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
J Perinat Med. 1995;23(1-2):13-7. doi: 10.1515/jpme.1995.23.1-2.13.
Erythropoietin, the glycoprotein which regulates erythropoiesis is unique amongst the hematopoietic growth factors since it is the only one which behaves like a hormone. Produced primarily in the kidneys in adults, erythropoietin interacts with erythroid precursors in the marrow to increase red cell production. Because erythropoietin behaves like a hormone, measurements of erythropoietin in the serum have proved useful in determining when production of this hormone is inadequate. Tissue hypoxia is the only physiologic stimulus for erythropoietin production and thus, with anemia, serum erythropoietin levels should be increased. Assuming normal marrow function and adequate nutrient supplies, when anemia is associated with a low serum erythropoietin level, it can be concluded that the anemia is in part due to erythropoietin lack and should be correctable by administration of erythropoietin. As a corollary, a high serum erythropoietin level (greater than 500 mU/ml) in the presence of anemia suggests that there is end organ failure, and erythropoietin therapy is not likely to be useful.
促红细胞生成素是一种调节红细胞生成的糖蛋白，在造血生长因子中独一无二，因为它是唯一一种表现得像激素的因子。促红细胞生成素主要在成人的肾脏中产生，它与骨髓中的红系前体细胞相互作用以增加红细胞生成。由于促红细胞生成素表现得像一种激素，血清中促红细胞生成素的测量已被证明有助于确定这种激素的产生何时不足。组织缺氧是促红细胞生成素产生的唯一生理刺激因素，因此，对于贫血患者，血清促红细胞生成素水平应该升高。假设骨髓功能正常且营养供应充足，当贫血与血清促红细胞生成素水平低相关时，可以得出结论，贫血部分是由于促红细胞生成素缺乏所致，并且通过给予促红细胞生成素应该可以纠正。作为一个推论，在贫血情况下血清促红细胞生成素水平高（大于500 mU/ml）表明存在终末器官衰竭，促红细胞生成素治疗可能无效。
