Crowley J P, Chazan J A, Metzger J B, Pono L, Valeri C R
Department of Medicine, Brown University, Providence, RI 02908.
Ann Clin Lab Sci. 1993 Jan-Feb;23(1):24-32.
Twenty-seven transfusion dependent patients with end-stage renal disease on long-term dialysis had blood cell counts, serum chemistries, blood pressure, and whole blood viscosity measured, as well as having transfusion requirements assessed. Three months after the institution of recombinant human erythropoietin (rHU-EPO) (75 u per kg per wk), there was an 88 percent fall in transfusion requirement. After four months, the hematocrit increased from 24 +/- 3.8 to 25.6 +/- 4.2 percent, mean corpuscular volume from 93 +/- 4.9 to 97 +/- 6.6 fl, 2-3-diphosphoglycerate (2,3-DPG) from 13.2 +/- 3.2 to 15.6 +/- 4.3 microM per g of Hb. Whole blood viscosity fell from 14.1 +/- 2.1 to 12.7 +/- 2.3 seconds, and ferritin levels fell from 3282 +/- 3889 to 2131 +/- 2441 ng per ml. In eight patients in whom the dose of rHU-EPO was further increased by up to 50 units per kg three times weekly for three months, the hematocrit rose further to 29.3 +/- 3.0 percent and the rise in hematocrit was accompanied by a further increase in 2,3-DPG to 17.9 +/- 2.8 microM per g of Hb (p < 0.03). There were no major side effects or vascular complications.
27名长期接受透析治疗的终末期肾病输血依赖患者接受了血细胞计数、血清化学指标、血压和全血粘度测量，并对输血需求进行了评估。在使用重组人促红细胞生成素（rHU-EPO，每周每千克体重75单位）三个月后，输血需求下降了88%。四个月后，血细胞比容从24±3.8%升至25.6±4.2%，平均红细胞体积从93±4.9飞升至97±6.6飞升，每克血红蛋白的2,3-二磷酸甘油酸（2,3-DPG）从13.2±3.2微摩尔升至15.6±4.3微摩尔。全血粘度从14.1±2.1秒降至12.7±2.3秒，铁蛋白水平从3282±3889纳克/毫升降至2131±2441纳克/毫升。在8名患者中，rHU-EPO剂量进一步增加至每周每千克体重最多50单位，每周三次，持续三个月，血细胞比容进一步升至29.3±3.0%，血细胞比容的升高伴随着每克血红蛋白的2,3-DPG进一步增加至17.9±2.8微摩尔（p<0.03）。未出现重大副作用或血管并发症。
