Laupacis A
Loeb Medical Research Institute, Ottawa Civic Hospital, Canada.
Semin Hematol. 1996 Apr;33(2 Suppl 2):51-3; discussion 54.
Several strategies have been investigated as a means of reducing allogeneic blood requirements in patients undergoing surgery, including the perioperative administration of epoetin alfa. In a multicenter, double-blind, placebo-controlled study in 208 patients undergoing elective hip replacement surgery, subcutaneous administration of epoetin alfa (300 IU/kg daily) for 14 or 9 days perioperatively (commencing 10 and 5 days preoperatively, respectively) significantly reduced the incidence of primary outcome events (any allogeneic blood transfusion or a postoperative hemoglobin [Hb] level < 8.0 g/dL) compared with placebo (P = .003). Furthermore, the transfusion requirements of epoetin alfa-treated patients were significantly lower than those of patients treated with placebo (P = .007). Preoperative and postoperative Hb levels and reticulocyte counts were higher in epoetin alfa-treated patients compared with placebo. Epoetin alfa was well tolerated, and the incidence of deep vein thrombosis (DVT) was not different from that observed in placebo recipients. Thus, perioperative administration of epoetin alfa reduces the allogeneic blood requirements of patients undergoing elective hip replacement surgery and is of particular benefit in the subgroup of patients whose baseline Hb levels are less than 13.5 g/dL.
为减少手术患者的异体血需求量，人们研究了多种策略，包括围手术期使用促红细胞生成素α。在一项针对208例接受择期髋关节置换手术患者的多中心、双盲、安慰剂对照研究中，围手术期皮下注射促红细胞生成素α（每日300 IU/kg）14天或9天（分别在术前10天和5天开始），与安慰剂相比，显著降低了主要结局事件（任何异体输血或术后血红蛋白[Hb]水平<8.0 g/dL）的发生率（P = 0.003）。此外，促红细胞生成素α治疗组患者的输血需求量显著低于安慰剂治疗组患者（P = 0.007）。与安慰剂相比，促红细胞生成素α治疗组患者术前和术后的Hb水平及网织红细胞计数更高。促红细胞生成素α耐受性良好，深静脉血栓形成（DVT）的发生率与安慰剂组观察到的发生率无差异。因此，围手术期使用促红细胞生成素α可减少择期髋关节置换手术患者的异体血需求量，对基线Hb水平低于13.5 g/dL的患者亚组尤其有益。
