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題名 | Serum Erythropoietin in Chronic Reanal Insufficiency Patients=慢性腎不全病人的血清紅血球生成素 |
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作者 | 陳逸洲; 葉瑞圻; 陳漢湘; 楊明矗; 王敏慧; 吳志仁; 施並富; |
期刊 | 中華民國腎臟醫學會雜誌 |
出版日期 | 19940600 |
卷期 | 8:2 1994.06[民83.06] |
頁次 | 頁96-101 |
分類號 | 415.815 |
語文 | eng |
關鍵詞 | Serum erythropoietin; Anemia; Glomerular filtration rate; Chronic renal insufficiency; |
中文摘要 | 貧血是慢性腎衰竭的主要臨床表徵之一,它會使這些病人生活品質變差。引起慢性腎衰竭病人貧血的原因主要為血清紅血球生成素產生不足。一般血清肌酸肝在 3.5rng/dl 以下的慢性腎不全病人很少會有貧血,但有些卻會出現。為了評估為何有些慢性腎不全的病人就出現貧血,我們測量慢性腎不全有貧血和無貧血病人的血清紅血球生成素。因此選擇了 27 位血清肌酸軒在 2-3rng/dl 的病人,其中 13 位有貧血 ( 第一組 ),14 位無貧血 ( 第二組 ),來測量它們的腎絲球過濾率和血清紅血球生成素。兩組病人只在血色素 (28.3±1.4 vs 40.0 ± 3.0%) 星有意義差別,而在腎絲球過濾率(45.5 ± 6.Ovs46.7 ± 8.6ml/min) 和血清紅血球生成素 (15.60 士 7.79vsl3.16 ± 6.28mU/m1) 並無差別。兩紅病人的血清紅血球生 成素大都在正常範闇 (8.2-21.4mU/m1),或稍高或稍低,自第一組有貧血病人亦是如此,顯示該組病人無法只因貧血所引致的缺氧,來刺激足夠的血清紅血球生成素產生,且可能有腎臟產生血清紅血球生成素的位置遭破壞的情形,這是有些慢性腎不全病人即已產生貧血的原因。由血液透析病人注射人工合成血清紅血球生成素即能完全改正貧血。我們認為慢性腎不全並有貧血的病人,亦需注射人工合成的血清紅血球生成素。 |
英文摘要 | Usual cases , the anemia rarely occurred in patients whose serum creatinine is below 3.5 mg/dl , but some exceptions exist. To evaluate the reason why some patients of chronic renal insufficiency had anemia, we tested serum erythropoietin in patients having chronic renal insufficiency with or without anemia. We selected 27 patients, whose serum creatinine was between 2 and 3 mg/dl. Group I included 13 patients with anemia, while group II included 14 patients without anemia We tested their glomerular filtration rate and serum erythropoietin level. Both groups had significant difference only in hematocrit (28.3 ± 1.4 vs 40.0±3.0%), but no significant differences in glomerular filtration rate(45.5± 6.0 vs 46.7 ± 8.6m/min) and serum erythropoietin level (15.60 ± 7.79 vs 13.16 ± 6.28 mu/ml). Serum erythropoietin levels in both groups were mostly within the normal range(8.2-21.4mU/ml). It was found in group I patients that erythropoietin production was insufficient in response to anemic hypoxia and possibly that the site of renal erythropoietin production was destroyed. That provides the explanation why some patients in chronic renal insufficiency stage had anemia. Cure of anemia with human recombinant erythropoietin treatment in hemodialysis patients showed that anemia is due to erythropoietin privation. We suggest that erythropoietin treatment is necessary for patients having chronic renal insufficiency with anemia. |
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