Perera R, Isola L, Kaufmann H
Department of Neurology, Mount Sinai School of Medicine, New York 10029, USA.
Clin Auton Res. 1995 Sep;5(4):211-3. doi: 10.1007/BF01824009.
Anemia is a common complication of autonomic failure and reduced red blood cell mass may contribute to the orthostatic hypotension of these patients. We investigated whether treatment with recombinant erythropoietin improves anemia and increases blood pressure in patients with primary autonomic failure. Three patients with multiple system atrophy and autonomic failure and one with pure autonomic failure were studied. All patients had normocytic normochromic anemia and low (n = 2) or normal (n = 2) serum levels of erythropoietin. Treatment with erythropoietin, 4000 U subcutaneously biweekly for 6 weeks, increased hematocrit and blood pressure in all patients. Hematocrit increased from 33.9 +/- 0.7 to 44.3 +/- 1.4%, blood pressure in supine position increased from 150 +/- 8/87 +/- 8 (systolic/diastolic; mean +/- SD) to 166 +/- 25/92 +/- 12 mmHg, and after 3 min in the head-up tilt position from 86 +/- 21/47 +/- 15 to 102 +/- 23/63 +/- 12 mmHg, (p < 0.05). All patients reported improvement in orthostatic symptoms and increased tolerance to standing. The study shows that treatment with erythropoietin improves anemia, increases blood pressure and ameliorates orthostatic hypotension in patients with primary autonomic failure.
贫血是自主神经功能衰竭的常见并发症，红细胞量减少可能导致这些患者出现体位性低血压。我们研究了重组促红细胞生成素治疗是否能改善原发性自主神经功能衰竭患者的贫血并升高血压。研究了3例多系统萎缩和自主神经功能衰竭患者以及1例单纯自主神经功能衰竭患者。所有患者均为正细胞正色素性贫血，促红细胞生成素血清水平低（2例）或正常（2例）。促红细胞生成素治疗，每两周皮下注射4000 U，共6周，所有患者的血细胞比容和血压均升高。血细胞比容从33.9±0.7%增至44.3±1.4%，仰卧位血压从150±8/87±8（收缩压/舒张压；均值±标准差）增至166±25/92±12 mmHg，头高位倾斜3分钟后从86±21/47±15增至102±23/63±12 mmHg，（p<0.05）。所有患者均报告体位性症状改善，站立耐受性增加。该研究表明，促红细胞生成素治疗可改善原发性自主神经功能衰竭患者的贫血、升高血压并改善体位性低血压。
