重组人促红细胞生成素治疗肾性贫血临床应用分析.docVIP

重组人促红细胞生成素治疗肾性贫血临床应用分析 　　【摘要】目的 了解重组人促红细胞生成素(rhEPO)治疗肾性贫血的临床效果，为临床合理用药提供依据。方法 对59例慢性肾性贫血患者采用皮下注射rhEPO治疗，每周三次，连续8周，同时补充右旋糖酐铁，叶酸和维生素B12，疗程结束后判定临床疗效，对比分析治疗前后Hb、网织红细胞(Rc)、红细胞压积(HCT)以及外周血异型红细胞百分率。结果 显效23例，有效27例，无效9例，总有效率为84.7%（50/59）;发生不良反应11例，其中血压增高6例，头痛3例，注射部位疼痛2例，经对症处理后好转，未影响治疗。治疗后HCT、Hb、Rc均明显升高，异型红细胞明显减少，治疗前后比较差异有统计学意义(P0.05) 。结论 rhEPO治疗肾性贫血，安全、有效，不良反应少，值得临床推广应用。 　　【关键词】重组人促红细胞生成素；肾性贫血；血红蛋白；红细胞压积；网织红细胞；异型红细胞 　　Recombinant human erythropoietin treatment of renal anemia Clinical application of 　　【Abstract】Objective Understanding of recombinant human erythropoietin (rhEPO) treatment of renal anemia clinical effect, provide the basis for the clinical use of drugs.Methods 59 cases of patients with chronic renal anemia treatment with rhEPO subcutaneously three times a week for 8 weeks andiron dextran, folic acid and vitamin B12, after treatment to determine clinical efficacy, compared before and after treatment Hb, reticulocyte Red blood cell (Rc), hematocrit (HCT) and the percentage of peripheral blood shaped red blood cells..Results 23 cases markedly effective in 27 cases, 9 cases, total effective rate was 84.7% (50/59); 11 cases of adverse reactions, including increased blood pressure in 6 cases, 3 cases of headache, injection site pain in 2 cases after symptomatic treatment improved, did not affect treatment. After treatment, HCT, Hb, Rc increased significantly, shaped red blood cells decreased significantly after treatment was significantly (P 0.05).Conclusions rhEPO treatment of renal anemia, safe, effective, less adverse reaction worthy of clinical application. 　　【Key words】Recombinant human erythropoietin; renal anemia; hemoglobin; hematocrit; reticulocytes; abnormal red blood cells 　　 　　肾性贫血是指各种因素造成肾脏促红细胞生成素（Epo）产生不足或尿毒症血浆中一些毒素物质干扰红细胞的生成和代谢而导致的贫血，是慢性肾功能不全发展到终末期常见的并发症。贫血的程度常与肾功能减退的程度相关。肾性贫血治疗方法主要有：透析、输血、药物治疗和中西医结合等。基因重组人类促红细胞生成素(rHuEpo)：rHuEpo是一种糖蛋白激素，作用部位在骨髓，使发育前期红细胞数目增加，改善贫血。作者采用rHuEpo治疗肾性贫血，同时补充右旋糖酐铁，叶酸和维生素B12等综合疗法，有效改变贫血，效果良好，现报告如下。 　　 　　1资料与方法