【摘要】 目的应用国产重组人促红细胞生成素(rhEPO)治疗观察慢性病贫血(ACD)患者,采用血清促红细胞生成素(sEPO)和血清转铁蛋白受体(sTfR)联合测定的方法,为临床ACD的诊断、鉴别诊断和疗效观察提供可靠的依据并指导治疗。方法根据治疗前sEPO水平分为治疗A组(sEPO<200mU/L)和治疗B组(sEPO>200mU/L),sEPO>500mU/L者不予入组。应用酶放大化学发光法检测sEPO,采用酶联免疫吸附试验(ELISA)测定sTfR,入组病例全部给予国产rhEPO治疗并进行疗效观察和结果分析。结果A组患者治疗前后血红蛋白(Hb)的变化较B组小,但差异有统计学意义(P<0.05),B组患者治疗前后Hb有较大变化,差异有统计学意义(P<0.01);rhEPO联合铁剂治疗ACD合并缺铁性贫血(IDA)收到较好的疗效;rhEPO治疗前后sEPO的变化与Hb呈负相关(r=-0.8812);骨髓铁染色和sTfR检测呈正相关。结论采用sTfR和sEPO联合检测的方法,提高了ACD的诊断、鉴别诊断及疗效,为ACD患者是否给予铁剂治疗提供了可靠的依据。应用国产rhEPO治疗ACD后,减少了输血次数,改善了各种贫血症状,降低了治疗费用,提高了治疗依从性,提高了患者生存质量。更多还原

【Abstract】 Objective To investigate the therapeutic efficacy of chronic disease(ACD) using domestic recombinant human erythropoietin(rhEPO) determined by serum erythropoietin(sEPO) and serum transferrin receptor(sTfR),and to provide reliable evidences and guidelines for the diagnosis,differential diagnosis and efficacy evaluation in ACD.Methods The level of sEPO was detected by enzyme-enlarged chemiluminescence analysis and sTfR by enzyme-linked immunosorbent assay(ELISA).The ACD patients(Hb<90 g/L) were assigned into Groups A(pre-treatment sEPO<200 mU/L) and B(pre-treatment sEPO>200 mU/L),excluded for those with pre-treatment sEPO>500 mU/L.The both groups received subcutaneous dosage(150 U·kg-1·d-1,three times a week) of domestic rhEPO for four consecutive weeks.Therapeutic effects were then observed and analyzed.Results The patients in Group A showed less,nevertheless statistically significant change from baseline Hb(P<0.05) compared with Group B,where an increase in Hb level was markedly evidenced(P<0.01).rhEPO combined with iron preparation demonstrated promising outcomes in ACD complicated with iron deficiency anemia.The variation of sEPO before and after rhEPO treatment was negatively correlated with Hb(r=-0.8812).A positive correlation was found between bone morrow aspirates stained for iron and sTfR measurement.Conclusion Combined monitoring using sTfR and sEPO showed benefits for diagnosis,differential diagnosis and efficacy evaluation in ACD,and provided reliable basis for identifying patients indicative of additional iron treatment.With domestic rhEPO,ACD patients experienced less need for transfusion,lower medical cost,better treatment compliance and improved quality of life.更多还原