新医学2012，Vol.43Issue(4)：223-227,5.DOI:10.3969/g.issn.0253-9802.2012.04.005
合并α-珠蛋白生成障碍性贫血对维持性血液透析患者使用促红素疗效的影响
Influence of alpha thalassemia incorporated in maintenance hemodialysis patients on the efficacy of erythropoietin
摘要
Abstract
Objective; To discuss the influence of alpha thalassemia incorporated in maintenance hemodialysis patients on the efficacy of erythropoietin ameliorating their anemia.Methods; Twelve maintenance hemodialysis patients with alpha thalassemia ( thalassemic group) were selected in guangzhou general hospital of guangzhou com -mand of PLA in recently three years.The correction of anemia and the response to erythropoietin in thalassemic group were studied and compared with those of the control maintenance hemodialysis patients(control group) who were matched for sex ,age, primary disease and body weight without thalassemia.Results; The baseline hemoglobin level of patients in thalassemic group was significantly lower than that in control group[ (55 ± 10)g/L vs (67 ± 6)g/L,P < 0. 01 ]. In the first three months ,the mean hemoglobin level of patients in thalassemic group was increased by only 22 g/L despite the erythropoietin dosage increased from 137 IU/ (kg·week)to 190 IU/ (kg·Week) ;and heart failure occurred in seven cases of thalassemic group(58% ) ,with only one case(8% ) in control group(P<0. 01). In the following three months,with the erythropoietin dosage of patients in thalassemic group up to 234 ±34 IU/kg/week,the hemoglobin level of them increased to 114 ±3g/L,and the anemia of them were corrected. The erythropoietin dosage requirement of patients in thalassemic group was significantly higher than that of patients in control group in the anemia correction phase and in the maintenance phase [ (249 ±22) vs ( 153 ±10)IU/ (kg·week),P<0.01;(198 ±21) vs(129±ll) IU/ (kg·week),P < 0. 01 ].There were no hange in MCV and MCH of the twelve patients in thalassemic group during the treatment(P > 0. 05).Conclusion; Alpha thalassemia could aggravate the anemia of maintenance hemodialysis patients , and their response to routine dose erythropoietin is poor.A higher dose of erythropoietin is required to correct their anemia ,but it cant change their MCV and MCH.关键词
血液透析/α-珠蛋白生成障碍性贫血/促红细胞生成素/临床疗效/并发症Key words
Renal dialysis/alpha thalassemia/Erythropoietin/Clinical therapeutic effect/Complication引用本文复制引用
黄俊,张虹,傅君舟,雷鸣..合并α-珠蛋白生成障碍性贫血对维持性血液透析患者使用促红素疗效的影响[J].新医学,2012,43(4):223-227,5.基金项目
广东省卫生厅医学科研基金资助课题(A2006495) （A2006495）
