肾移植术前患者应用大剂量促红素的临床研究

探索肾移植术前患者应用大剂量促红素(50 IU.kg-1.day-1)纠正严重贫血以达到手术要求的可行性和有效性。70例尿毒症严重贫血患者据是否有肾移植要求分为A、B组,A组每日皮下注射促红素50IU/kg,待血红蛋白(hemoglo-bin,HGB)上升至80g/L,改为常规剂量维持等待肾移植手术施行。B组按常规剂量应用促红素。治疗期间,监测血常规、血生化、血液流变学、血压等指标及患者出现的各种不良反应。结果显示,两组患者自治疗2、3、4周后血红蛋白值均有显著性差异,血生化、肝功系列值、血液流变学、血压结果差异无统计学差异。因此肾移植术前患者应用大剂量促红素可避免多项肾移植不利因素,可较好地解决肾移植术前贫血这一难题。

High--dose Erythropoietin to Treat Severe Anemia Before Renal Transplantation

To investigate the feasibility of using high--dose erythropoietin （50 IU/kg/day） to treat pretransp/antation severe anemia,70 hemodialysis patients with severe uremic anemia in our hospital were enrolled in the study. Among them, 40 patients waiting for renal transplantation received high--dosage erythropoietin （50 IU/kg/day）, and the other 30 patients received normal--dosage erythropoietin （50 IU/kg , 3 times per week） as controls. The study was ended by the HGB level 〉 80g/L or treatment of 5 weeks. During of the study, blood pressure and blood levels of HGB, potassium, glutamate--pyruvate transaminase and whole--blood high--specific viscosity were monitored. The mean HGB level in the high--dosage group was significantly greater than that in the normal--dosage group at weeks 2, 3 and 4 after treatment began （all P〈0.01）. The two groups did not differ in blood pressure, blood levels of potassium, glutamate--pyruvate transaminase or whole--blood high--specific viscosity. Therefore, the high--dose erythropoietin therapy could treat ure mic anemia and avoid some harmful effects, and is appropriate for patients waiting for renal transplantation.