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大剂量促红细胞生成素低频率治疗肾性贫血的效果研究

2021-10-09秦盼盼汪洪吴六国

上海医药 2021年17期

秦盼盼 汪洪 吴六国

摘 要 目的:探讨促红细胞生成素(erythropoietin, EPO)10 000 U低频率治疗肾性贫血的效果。方法:选取行血透的尿毒症患者79例,按药物剂量将其分为高剂量组(n=39)与低剂量组(n=40)。高剂量组采用EPO 10 000 U每周1次+多糖铁复合物联合低通量透析,低剂量组采用EPO 3 000 U每周3次+多糖铁复合物联合低通量透析。治疗4个月后,观察两组疗效及实验室各项指标水平和不良反应情况。结果:治疗后,高剂量组、低剂量组总有效率分别为92.31%、87.50%(P>0.05)。高剂量组红细胞压积、血红蛋白、转铁蛋白饱和度、血清铁蛋白水平明显升高,且高于低剂量组(P<0.05)。在用药期间两组患者均未出现明显不良反应。结论:应用促红细胞生成素10 000 U每周1次、多糖铁复合物联合低通量透析仪器治疗肾性贫血效果高效,耐受性好且安全。

关键词 肾性贫血 促红细胞生成素 低频率

中图分类号:R973.3; R556.9 文献标志码:B 文章编号:1006-1533(2021)17-0034-03

Effect of high dosage erythropoietin at low frequency on renal anemia

QIN Panpan, WANG Hong, WU Liuguo

[Department of Nephrology, Guangan Peoples Hospital (West China Guangan Hospital of Sichuan University), Guangan 638500, China]

ABSTRACT Objective: To investigate the effect of erythropoietin 10 000 U at low frequency on renal anemia. Methods: Seventy-nine uremic patients undergoing hemodialysis were divided into a high dosage group (n=39) and low dosage group(n=40) according to drug dosage. The high dosage group received EPO 10 000 U once a week combined with low-flux dialysis, and the low dosage group received EPO 3 000 U three times a week combined with low-flux dialysis. After 4 months of treatment, the therapeutic effects, laboratory indexes and adverse reactions were observed. Results: After treatment, Overall response rate was 92.31% in the high dosage group and 87.50% in the low dosage group (P>0.05). The levels of hematocrit, hemoglobin, transferrin saturation, and serum ferritin were increased in both groups and furthermore were significantly higher in the high dosage group than the low dosage group (P<0.05). There were no obvious adverse reactions in either group during the treatment. Conclusion: Erythropoietin 10 000 U once a week, polysaccharide iron complex combined with low-flux dialysis apparatus for renal anemia is effective with good tolerability and safety.

KEy WORDS renal anemia; erythropoietin; low frequency

腎性贫血(renal anemia, RA)是由于肾功能受损,肾脏分泌的促红细胞生成素(erythropoietin, EPO)相对或绝对不足导致的贫血[1],以及尿毒症患者血浆中一些毒性物质通过对红细胞的生成与代谢进行干扰而造成的贫血[2],临床表现为心悸、头晕、嗜睡等。RA是慢性肾脏病的常见并发症,也是慢性肾脏病患者合并心血管并发症的独立危险因素。临床上血液透析虽然可以改善患者的临床症状,但无法根治患者的贫血。国内外已大量文献证实,采用EPO治疗RA疗效佳[3]。既往临床多给予EPO 3 000 U每周3次皮下注射的方法治疗RA,但采用10 000 U每周1次的方法治疗RA报道并不多。本研究旨在对39例患者采用EPO 10 000 U每周1次治疗,分析治疗效果及其对患者实验室指标的影响,为临床治疗RA提供理论基础与依据。

1 资料与方法

1.1 一般资料

选取2019年1月—2019年12月我院收治的进行维持性血液透析的尿毒症患者79例。纳入……

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