Souweine B, Serre A F, Philippe P, Conio N, Aumaitre O, Marcheix J C
Service de Médecine Interne, CHU, Clermont-Ferrand, France.
Ann Med Interne (Paris). 1995;146(1):8-12.
The role of erythropoietin in the pathogenesis of anaemia associated with inflammatory disorders is unclear. We studied serum erythropoietin levels in patients with inflammatory process of varying aetiologies. Serum erythropoietin levels and reticulocyte counts were prospectively measured in 40 patients with inflammatory syndromes and compared with values obtained in 20 patients with myelodysplastic syndromes. Significant inverse correlation between erythropoietin levels and haemoglobin concentration were noted in the 2 groups. The slope of the regression line for patients with inflammatory disorders was lower as compared with that for the myelodysplastic syndromes. In all cases, when the erythropoietin response in relation to degree of anaemia is compared with that which occurs in patients with myelodysplastic syndromes, the inadequate erythropoietin response in patients with chronic inflammatory process becomes evident. In patients with inflammatory process, a relationship between erythropoietin levels and reticulocyte counts were only noted in patients with mildly anaemia (haemoglobin concentration higher than 10.5 g/dl). This study suggests blunted erythropoietin production and impaired marrow response to this hormone in the anaemia which occurs in inflammatory syndromes and supports the hypothesis that these disorders may contribute to the development of the anaemia associated with inflammatory disorders.
促红细胞生成素在炎症性疾病相关贫血发病机制中的作用尚不清楚。我们研究了不同病因炎症过程患者的血清促红细胞生成素水平。前瞻性地测定了40例炎症综合征患者的血清促红细胞生成素水平和网织红细胞计数，并与20例骨髓增生异常综合征患者的值进行比较。两组中促红细胞生成素水平与血红蛋白浓度之间均存在显著负相关。与骨髓增生异常综合征患者相比，炎症性疾病患者的回归线斜率更低。在所有病例中，当将炎症性疾病患者相对于贫血程度的促红细胞生成素反应与骨髓增生异常综合征患者的反应进行比较时，慢性炎症过程患者促红细胞生成素反应不足就变得明显了。在炎症性疾病患者中，仅在轻度贫血（血红蛋白浓度高于10.5 g/dl）患者中发现促红细胞生成素水平与网织红细胞计数之间存在关联。这项研究表明，在炎症综合征所致贫血中促红细胞生成素产生减弱且骨髓对该激素的反应受损，并支持这些疾病可能导致炎症性疾病相关贫血发生的假说。
