| 应俊,黄坚.终末期肾病伴纯红再障8例临床分析及文献复习[J].浙江中西医结合杂志,2015,25(2): |
| 终末期肾病伴纯红再障8例临床分析及文献复习 |
| Clinical Analysis on Uremic Patients with PRCA by Eight Cases Reports and Literatures Review |
| 投稿时间：2014-07-02 修订日期：2014-09-09 |
| DOI： |
| 中文关键词: 终末期肾脏病 促红素 纯红再障 治疗 |
| 英文关键词:ESRD(Uremic) rhuEPO Pure red cell aplasis Therapy |
| 基金项目: |
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| 中文摘要: |
| 【】目的：回顾性分析我院近年诊治的终末期肾病伴发纯红再障8例并复习相关文献,以探讨EPO抗体介导的PRCA的诊断与治疗。方法：8例终末期肾病的患者,在运用rHuEPO-α治疗中突发血红蛋白浓度进行性下降,网织红细胞计数减少,加大rHuEPO-α皮下注射的剂量,贫血加重无改善。在排除造血原料缺乏、失血、溶血、自身免疫系统疾病等因素后,行骨髓检查提示单纯红细胞再生障碍性贫血骨髓象,符合纯红再障诊断,8例患者均停用rHuEPO,2例行肾移植术,余均予环孢菌素A联合十一酸睾丸酮进行免疫抑制治疗。结果：2例肾移植患者痊愈,免疫抑制治疗后4例患者得到不同程度的缓解。结论：环抱菌素联合雄激素治疗EPO抗体介导的PRCA有效,肾移植术则更具治疗优势。 |
| 英文摘要: |
| 【】 Objective：This paper aims to analyze the diagnosis and the treatment of EPO antibody-mediated PRCA by surveying eight cases of uremic patients acquired PRCA in our department, and meanwhile by reviewing relevant literatures. Methods：It is found that the hemoglobin and the reticulocyte cout of the eight uremia patients suddenly decreased in the process of using rHuEPO-α. If increasing the dose of the drug,the symptoms actually worsened without any imoprovement. Then, in order to exclude the lack of hematopoietic raw materials、blood loss、hemolysis、autoimmune diseases etc,PRCA was diagnosed with no objection by bone marrow biopsy. All patients were stopped using rHuEPO-α, two was healed by renal transplation, and the others by cyclosporineA and androgen. Results：Two patients healed by renal transplation were recovered,and sysmptom in four cases was eased in different degrees after using immunosuppressants. Conclusion：The treatment of cyclosporine and androgen is effective,but renal transplation is more effective. |
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