Rault R, Magnone M
Department of Medicine, University of Pittsburgh, Pennsylvania 15213-2500, USA.
ASAIO J. 1996 Sep-Oct;42(5):M901-3. doi: 10.1097/00002480-199609000-00123.
Hyperparathyroidism has been implicated as a cause for resistance to erythropoietin therapy, based on a limited number of studies. The authors retrospectively surveyed the effects of parathyroidectomy on hematocrit and erythropoietin dose in patients with end-stage renal disease. The study group included 10 patients (4 men, 6 women) on long-term hemodialysis, 9 of whom were receiving erythropoietin intravenously during dialysis. Parathyroidectomy resulted in a decrease in mean parathormone levels from 15 times normal preoperatively to 2.3 times normal at follow-up. The hematocrit values increased, and the weekly erythropoietin dose decreased significantly when values 1 month before surgery were compared with those 6 months after surgery. From this, the authors conclude that secondary hyperparathyroidism is a cause of worsening anemia and increased erythropoietin requirements in patients on hemodialysis, and that parathyroidectomy is effective in reversing these abnormalities.
基于有限的一些研究，甲状旁腺功能亢进被认为是促红细胞生成素治疗抵抗的一个原因。作者回顾性调查了甲状旁腺切除术对终末期肾病患者血细胞比容和促红细胞生成素剂量的影响。研究组包括10例长期接受血液透析的患者（4例男性，6例女性），其中9例在透析期间静脉注射促红细胞生成素。甲状旁腺切除术后，平均甲状旁腺激素水平从术前高于正常水平15倍降至随访时高于正常水平2.3倍。将手术前1个月的值与手术后6个月的值进行比较时，血细胞比容值升高，每周促红细胞生成素剂量显著降低。由此，作者得出结论，继发性甲状旁腺功能亢进是血液透析患者贫血加重和促红细胞生成素需求增加的一个原因，并且甲状旁腺切除术可有效逆转这些异常情况。
