摘要
应用人基因重组红细胞生成素（ｒＨｕＥｐｏ）治疗１０６例尿毒症腹透患者贫血。治疗前Ｈｃｔ≤２５％。起始剂量１００Ｕ／Ｋｇ，每周３次。病例随机分为皮下和静脉治疗组。结果治疗后所有患者贫血均有明显纠正，２０周内９６．２％患者Ｈｃｔ≥３０％。维持剂量为１８７Ｕ．ｋｇ（－１）周。皮下组治疗早期Ｈｃｔ上升幅度显著高于静脉组，维持剂量亦显著低。缺铁、血浆ＰＴＨ明显升高和感染等降低ｒＨｕＥｐｏ疗效。治疗２０周血压升高和缺铁发病率分别为２８．３％和２３．３％。老年患者疗效稍差，易出现血压升高和缺铁。研究表明，ｒＨｕＥｐｏ能有效纠正尿毒症腹透患者贫血，皮下注射疗效较好，应密切随访血压和铁代谢等。
06 CAPD patients with
uncomplicated anemia re-ceived treatment of rHuEpo for 5 ￣ 24 months. Thepatients were
divided randomly into subcutaneous ts.c) or intravenous (i. v.) group. The results showedthat
anemia was ameliorated significantly in all patientsand Hct over 30/a0 in 96. 2/00 of patient
within 20weeks. Erythrocyte transfusions were eliminated in allpatients. More than 50%～70%
of patients experi-enced improved physical strength. appetite. sleep.einotion. family and social
relationship. Comparedwith i. v. group, Hct increased more rapid in initialtreatment phase and
the maintenance dose was lowersignifieantly in s. c. group. The factors contributed topoor
responses of rHuEPo included iron deficiency,hyperparathyroidism, inflammation and chronic
bleed-ing. The significant increase of platelet counts , red cellaggregation at both low and high
shear rate and plasmafibrinogen concentration were found 3～5 months aftertreatment.The
cardiac output, cardiac stroke volumeand cardiac index decreased while total peripheral
resis-tance increased significantly in & patients 3￣5 momthsafter treatment. Adverse effects
included increasedblood pressure (28. 3%), iron deficiency(23. 3%) ,hypertension crisis (0. 09%)
, hyperpotassemia (4.9%) and flu-like symptom (1. 96%).
出处
《中华肾脏病杂志》
CAS
CSCD
北大核心
1995年第1期10-12,共3页
Chinese Journal of Nephrology
