摘要
目的观察应用大剂量rHuEPO(重组促红细胞生成素)治疗肾性贫血患者时对机体可溶性转铁蛋白受体(sTfR)及其相关铁代谢的影响。方法对36例肾性贫血患者给予rHuEPO 1万IU皮下注射,每周1次,连续8周,在治疗前后分别采血、行骨髓穿刺检查以检测血中sTfR、血清铁蛋白(SF)、血清铁(SI)、促红细胞生成素(EPO)及红细胞计数(RBC)、血红蛋白(Hb)、红细胞压积(Hct)、网织红细胞计数(Ret%)和骨髓外铁、铁粒幼细胞、总红系所占百分数(E%)并进行自身对照。结果患者治疗后sTfR显著增高(P<0.01);而骨髓外铁、铁粒幼细胞、SF均显著降低;红系增生较治疗前明显活跃(P<0.01)。sTfR与RBC呈正相关(r=0.632,P<0.01);与Hct呈正相关(r=0.757,P<0.01);与骨髓E%呈正相关(r=0.775,P<0.01);与其他参数无相关性。结论sTfR在大剂量重组促红细胞生成素治疗肾性贫血患者后迅速升高,作为一种新的评价治疗效果的指标,不仅准确地反映机体铁贮存状况,也反映机体骨髓红细胞的增殖活性。
Objective To study the effect of high dose of rHuEPO for renal anemia on soluble transferrin receptor and related iron metabolism. Methods Thirty-six patients with renal anemia received treatment of high dose of rHuEPO injection subcutaneous for 8 weeks,blood and bone marrow aspiration were performed within the first day of admission and repeated 8 weeks later, observed the variation of sTfR, serum ferritin, serum iron, EPO, RBC, Hb, HCT, Ret counts, sideroblast counts and erythroid percent before and after the therapy. Results After the therapy, the sTill and erythron increased significantly,but bone marrow iron deposits decreased progTessively as HCT increased. The sTfR had a apositive correlation with RBC （r = 0. 632,P 〈 0. 01 ） and positive correlation with Hct （r = 0. 757,P 〈 0. 01 ） and positive correlation with E% （r = 0. 775, P 〈 0. 01 ） . No correlations were observed among sTFR and other parameters. Conclusion After high dose of rHuEPO is effective in treatment of renal anemia, sTfRwas significantly higher;sTfR is a new iron parameter for diagnosis with significant value in differential iron deficiency diseases. It not only reflects iron store status of patients,but also reflects erythropoietic activity of bone marrow in patients with renal anemia.
出处
《潍坊医学院学报》
2007年第5期451-453,I0003,共4页
Acta Academiae Medicinae Weifang
