Nydegger U
Central Laboratory of Hematology, University Hospital, Berne, Switzerland.
Semin Hematol. 1996 Apr;33(2 Suppl 2):39-40; discussion 41-2.
In the setting of elective orthopedic surgery, epoetin alfa has been shown to facilitate autologous blood (AB) donation and reduce allogeneic blood requirements. However, the most appropriate dose and route of administration remains to be defined. A randomized, double-blind, placebo-controlled study was therefore conducted to compare the effect of different subcutaneous (s.c.) doses of epoetin alfa on hemoglobin (Hb) and endogenous erythropoietin (EPO) levels and transfusion requirements in 62 patients donating AB prior to hip surgery. Epoetin alfa (100 or 200 IU/kg s.c. on days -30, -23, -16, and -9 prior to surgery, in conjunction with oral iron supplementation) dose-dependently ameliorated the reduction in Hb levels associated with AB donation. No patient treated with epoetin alfa required allogeneic blood compared with two placebo recipients (one of whom required additional blood because of reoperation). The results of this study confirm that relatively low dosages of epoetin alfa minimize the decrease in Hb levels during AB donation and help to reduce exposure to allogeneic blood in patients scheduled for elective orthopedic surgery.
在择期骨科手术中，已证明促红细胞生成素α有助于自体血（AB）捐献并减少异体血需求。然而，最合适的剂量和给药途径仍有待确定。因此，进行了一项随机、双盲、安慰剂对照研究，以比较不同皮下（s.c.）剂量的促红细胞生成素α对62例髋关节手术前捐献AB血的患者血红蛋白（Hb）和内源性促红细胞生成素（EPO）水平以及输血需求的影响。促红细胞生成素α（在手术前第-30、-23、-16和-9天皮下注射100或200 IU/kg，并联合口服铁剂补充）剂量依赖性地改善了与AB血捐献相关的Hb水平降低。与两名接受安慰剂的患者（其中一名因再次手术需要额外输血）相比，接受促红细胞生成素α治疗的患者均无需异体血。这项研究的结果证实，相对低剂量的促红细胞生成素α可将AB血捐献期间Hb水平的降低降至最低，并有助于减少择期骨科手术患者接触异体血的机会。
