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基因重组人工促红细胞生成素对血液透析患者贫血的疗效观察

THE OBSERVATION OF THERAPY ANEMIA OF CHRONIC RENAL FAILURE WITLH RECOMBINANT HUMAN ERYTHROPOIETN

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【作者】 姜筠刘平王二军金其庄

【Author】 Jiang Yin;Liu Pin;Wang Er-jun,et al .(First Hospotal,Beijng Medical University,Beijng 100034)

【机构】 北京医科大学第一医院肾内科

【摘要】 贫血是慢性肾衰的严重并发症之一,而使用基因重组人工促红细胞生成素(r-HuEPO)可迅速纠正贫血。大多数患者r-HuEPO治疗起始量为100U/kg,每周3次静脉或皮下注射,6周后Hb可升至100g/L,红细胞压积(Hct)升至0.33~0.35以上,改用维持量50U/kg,每周3次。其中4例患者需要增大剂量为150U/kg,每周3次。疗效较差的原因与反复肺感染、营养摄入不足、铁的缺乏有关。所以治疗中应补充铁、叶酸、VitB_(12),对存在感染应积极控制。随着血红蛋白(Hb)及Hct上升,2/3病人出现高血压可通过药物控制;透析中易发生透析器及管路凝血,应增加肝素用量;易发生高钾血症,应做到充分透析。

【Abstract】 nemia is one of the serious complications of chronic renal failure,therapy with recombinant hu-man erythropoietin(r-HuEPO)can correct such anemia officiently.For most patients,the initial doseof r-HuEPO is 100U/kg, by intravenously or subcutaneous, three time a week.After 6 weeks oftreatment, Hb could increase to 100g/L,and Hct to above 0.33~0.35.Then 500/kg 3 time a weekcan be used as maintaining dose. 4 patients need maintaining dose of 150U/kg,for pulmonary infec-tion,poor nutrition,and poor iron supply.Therefore, during the treatment,iron folie acid and VitB12 should be sapplied sufficiently and treat the infection effectively with the increasing of Hb and Hct,2/3 of the patients have hypertension which can be controled with medication. If there is thrombosis inthe dialyzer, the dose of heparin should be increased,The patients on r-HuEPO should be dialysisedsufficiently to prevent hyperkalemia.

  • 【文献出处】 中华内科杂志 ,CHINESE JOURNAL OF INTERNAL MEDICINE , 编辑部邮箱 ,1994年02期
  • 【分类号】R459.5
  • 【被引频次】7
  • 【下载频次】59
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