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[肾移植后的促红细胞生成素与红细胞生成]

[Erythropoietin and erythropoiesis after kidney transplantation].

作者信息

Zadrazil J, Bachleda P, Grosmanová T, Zahálková J, Fingerová H, Petrová P, Novotný D

机构信息

III. interní klinika, FN Olomouc.

出版信息

Vnitr Lek. 1996 Aug;42(8):540-4.

PMID:8967023
Abstract

In a group of 15 patients after the first transplantation of a cadaverous kidney the authors monitored for the period of one month the serum erythropoietin concentration (Epo), haemoglobin levels (Hb), the haematocrit (Ht) and serum creatinine (Cr). The objective of the investigation was to evaluate in relation to serum concentrations of Epo and the function of the graft. Erythropoietin was examined by the authors own method before and after transplantation during the first 10 days daily and then on the 12th, 15th, 20th, 25th and 30th day. Normal values are 22-44 mU/ml. The mean Epo value before transplantation was 41.9 +/- 18.8 mU/ml. After transplantation the highest mean value of Epo was recorded on the second day when it reached a value of 102.8 +/- 144 mU/ml. The mean Epo serum concentration at the end of the study was 45.9 +/- 20.9 mU/ml and did not differ significantly from values recorded before transplantation. Between Hb and Ht values and Epo serum concentrations no correlation was revealed. Conversely, statistical analysis revealed a close inverse relationship between the drop of creatininaemia and the rise of Hb and Ht values. From the results of the investigation ensues that the decisive condition for the onset of the erythropoietic response after renal transplantation is adjustment of the milieu interiéur, induced by the restored excretory function of the graft which creates prerequisites for a normal response of the bone marrow to Epo.

摘要

在一组15例首次接受尸体肾移植的患者中,作者在一个月的时间内监测了血清促红细胞生成素浓度(Epo)、血红蛋白水平(Hb)、血细胞比容(Ht)和血清肌酐(Cr)。研究目的是评估与Epo血清浓度及移植肾功能的关系。作者采用自己的方法在移植前后的前10天每天检测促红细胞生成素,然后在第12、15、20、25和30天检测。正常数值为22 - 44 mU/ml。移植前Epo的平均值为41.9 +/- 18.8 mU/ml。移植后Epo的最高平均值在第二天记录到,达到102.8 +/- 144 mU/ml。研究结束时Epo血清浓度的平均值为45.9 +/- 20.9 mU/ml,与移植前记录的值无显著差异。未发现Hb和Ht值与Epo血清浓度之间存在相关性。相反,统计分析显示肌酐血症的下降与Hb和Ht值的升高之间存在密切的负相关关系。从研究结果可以得出,肾移植后红细胞生成反应开始的决定性条件是内环境的调整,这是由移植肾恢复的排泄功能诱导的,为骨髓对Epo的正常反应创造了前提条件。

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