Goodnough L T, Price T H, Parvin C A, Friedman K D, Vogler W R, Khan N, Sacher R, Johnston M, Wissel M, Ciavarella D
Washington University School of Medicine, Division of Laboratory Medicine, St Louis, MO 63110.
Br J Haematol. 1994 Aug;87(4):695-9. doi: 10.1111/j.1365-2141.1994.tb06725.x.
Recombinant human erythropoietin (EPO) therapy has been shown to increase red blood cell (RBC) production and facilitate autologous blood donation before elective surgery. However, recent reports have suggested that surgery and/or EPO therapy may suppress endogenous erythropoietin secretion in response to anaemia. We therefore analysed the haemoglobin/erythropoietin relationship preoperatively and postoperatively in 71 autologous blood donors subjected to aggressive phlebotomy and six treatments with either EPO (150 U/kg, n = 16, 300 U/kg, n = 18, or 600 U/kg, n = 19) or placebo (n = 18). Using data from the three preoperative study visits, the linear relationship between log erythropoietin and haemoglobin was determined for each of the 18 placebo patients. We found no significant differences in the slopes of the relationships in this group during aggressive phlebotomy. Furthermore, there was no evidence of a significant difference in the erythropoietin level recorded postoperatively for each patient to that predicted from the patient's postoperative haemoglobin level, based on the haemoglobin/log erythropoietin relationship preoperatively. Similarly, for each of the EPO-treated groups, there was no evidence of a significant difference when comparing the recorded erythropoietin level to that predicted from each patient's postoperative haemoglobin level, based on the haemoglobin/log erythropoietin relationship preoperatively. We conclude that preoperative recombinant human erythropoietin therapy and/or surgery do not adversely affect the postoperative erythropoietin response to anaemia.
重组人促红细胞生成素（EPO）疗法已被证明可增加红细胞（RBC）生成，并有助于在择期手术前进行自体献血。然而，最近的报告表明，手术和/或EPO疗法可能会抑制内源性促红细胞生成素对贫血的分泌反应。因此，我们分析了71名接受积极放血的自体献血者以及接受EPO（150 U/kg，n = 16；300 U/kg，n = 18；或600 U/kg，n = 19）或安慰剂（n = 18）六种治疗的患者术前和术后血红蛋白/促红细胞生成素的关系。利用术前三次研究访视的数据，确定了18名安慰剂患者中每一位促红细胞生成素对数与血红蛋白之间的线性关系。我们发现在积极放血期间该组关系的斜率没有显著差异。此外，根据术前血红蛋白/促红细胞生成素对数关系，没有证据表明每位患者术后记录的促红细胞生成素水平与根据患者术后血红蛋白水平预测的水平存在显著差异。同样，对于每个EPO治疗组，将记录的促红细胞生成素水平与根据术前血红蛋白/促红细胞生成素对数关系从每位患者术后血红蛋白水平预测的水平进行比较时，也没有证据表明存在显著差异。我们得出结论，术前重组人促红细胞生成素疗法和/或手术不会对术后促红细胞生成素对贫血的反应产生不利影响。
