Debska-Slizień A, Biedunkiewicz B, Rutkowski B
Kliniki Chorób Nerek, Akademii Medycznej w Gdańsku.
Pol Arch Med Wewn. 1994 Sep;92(3):207-15.
For proper erythropoietic response to r-Epo iron, folic acid and B12 vitamin are needed. Iron deficiency is the most common in uremic patients treated with r-Epo. So the aim of presented study was to measure hematological and iron status changes. Studies were carried out in 23 anemic, uremic, hemodialysis patients. They were divided into two groups, the first HDa--5 people (3W, 2M) aged 23-49 (mean 34 +/- 12) years and the second HDb 18 patients (11W, 7M) aged 21-56 (mean 38 +/- 12) years. Mean hemoglobin (HGB) before r-Epo was 6.9 +/- 1.0 g/dl in HDa, and 6.7 +/- 1.1 g/dl in HDb. r-Epo in HDa group was given during 12 weeks i.v. and afterwards s.c. for other 4 weeks with initial dose 3 x 50 u/kg b.w. (mean during 4 months 65 +/- 24 u/kg m.c. 3 times weekly). Patients from HDb group received r-Epo during 12 months only s.c. with initial dose 2000 u three times per week (mean during 12 months 26 +/- 4 u/kg m.c. 3 times weekly). Dose of r-Epo was changed accordingly to HGB concentration to keep it between 10-12 g/dl. Blood morphological parameters were monitored weekly using hematological autoanalyser Technicon H1, simultaneously an iron status indicators as iron, transferrin and ferritin were measured. An increase of HGB concentration, erythrocytes count and Ht value was observed in all patients (I-HGB 10.1 +/- 2.9, II-HGB 9.2 +/- 1.6).(ABSTRACT TRUNCATED AT 250 WORDS)
为了使机体对重组促红细胞生成素(r-Epo)产生适当的红细胞生成反应,需要铁、叶酸和维生素B12。缺铁是接受r-Epo治疗的尿毒症患者中最常见的情况。因此,本研究的目的是测量血液学和铁状态的变化。研究对象为23例贫血、尿毒症、接受血液透析的患者。他们被分为两组,第一组HDa为5人(3名女性,2名男性),年龄在23 - 49岁(平均34±12岁);第二组HDb为18例患者(11名女性,7名男性),年龄在21 - 56岁(平均38±12岁)。HDa组在r-Epo治疗前平均血红蛋白(HGB)为6.9±1.0 g/dl,HDb组为6.7±1.1 g/dl。HDa组静脉注射r-Epo 12周,之后皮下注射4周,初始剂量为3×50 U/kg体重(4个月期间平均65±24 U/kg体表面积,每周3次)。HDb组仅皮下注射r-Epo 12个月,初始剂量为每周3次,每次2000 U(12个月期间平均26±4 U/kg体表面积,每周3次)。根据HGB浓度相应调整r-Epo剂量,使其保持在10 - 12 g/dl之间。每周使用Technicon H1血液自动分析仪监测血液形态学参数,同时测量铁、转铁蛋白和铁蛋白等铁状态指标。所有患者的HGB浓度、红细胞计数和血细胞比容值均有所增加(I-HGB 10.1±2.9,II-HGB 9.2±1.6)。