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頁籤選單縮合
題 名 | Human Recombinant Erythropoietin and Phlebotomy in the Treatment of Iron Overload in Uremic Patients=人工合成紅血球生成素合併放血對治療尿毒病人鐵沈著症的效果 |
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作 者 | 陳國書; 呂美玲; 黃秋錦; | 書刊名 | 長庚醫學 |
卷 期 | 18:3 1995.09[民84.09] |
頁 次 | 頁248-253 |
分類號 | 415.816 |
關鍵詞 | 放血治療; 人工合成紅血球生成素; 鐵沈著症; 血液透析; 尿毒症; Phlebotomy; Erythropoietin; Iron overload; Ferritin; Hemodialysis; |
語 文 | 英文(English) |
中文摘要 | 在過去未使用紅血球生成素以前,經常以輸血來治療尿毒症造成的貧血。所以不少尿毒患者合併有鐵沈著過多的現象。自從使用了紅血球生成素後,因為紅血球的製造增加,促進了鐵的利用,所以輕度的鐵沈著症常可得到明顯改善,可是對於中度或重度的病患,效果往往不理想。本研究報告了六例有鐵沈著症的尿毒患者,三例屬於輕輕度的病患在長期使用紅血球生成素治療後,得到明顯的改善;可是另外三例重度患者,則必須合併放血治療才能改善鐵沈著過多的現免。此一觀察證實了放血對治療重度鐵沈著症的效果以及其必要性。 |
英文摘要 | Six chronic hemodialysis patients suffering from iron overland (serum ferritin ranged between 2053-15704μg/L) were trated with human recombinant erythropoietin (EPO) alone for eighteen months. An initial rapid decrease of serum ferritin was observed in all six patients when the loading dose of EPO was given. Three patients (Cases 4, 5, 6) who suffered from chronic blood loss maintained a continuous decline of serum ferritin in the subsequent stage of maintenance dose EPO therapy, however, the decrease of serum ferritin became slugglish under a maintenance dose in other three patients (Case 1, 2 and 3). The serum ferritin eventually decreased to a satisfactory level (975-1761μg/L) in Cases 4, 5 and 6, whereas it remained high (4232-8196μg/L) in Cases 1, 2 and 3 who had higher basal levels of serum ferritin (5641-15704μg/L) and a plateau of response under a maintenance dose of EPO. These three patients were then treated with EPO and phlebotomy. Their serum ferritin decreased quickly from 6752±1264μg/L to 2454±482μg/L after six months of phlebotomy therapy; it was a dramatic improvement in contrast to the stagnant response under a maintenance dose of EPO alone. Our experience indicates that EPO therapy alone has its limitations in treating severe iron overload. Although there is an initial rapid decrease of serum ferritin during the period of the loading dose, the response might become stagnant during the period of maintenance dose. Phlebotomy effectively eliminated the excessive iron stores in these refractory cases. Therefore, we suggest that phlebotomy be considered in severe iron overload if a stagnant response is observed under a maintenance dose EPO therapy. |
本系統中英文摘要資訊取自各篇刊載內容。