两种方案治疗肾衰血液透析病人贫血疗效对比

目的对比促红细胞生成素(erythropoietin,EPO)常规疗法与其联用左卡尼汀和苯丙酸诺龙对慢性肾衰血液透析病人贫血的疗效。方法选择28例慢性肾衰血透病人,随机分为A,B两组,A组给予EPO和补充叶酸、铁剂、维生素B12等常规治疗,B组除上述治疗外,加用苯丙酸诺龙、左卡尼汀。观察用药12周后贫血改善情况。结果两组病人治疗后贫血均有改善。B组改善更为明显。结论促红细胞生成素联合苯丙酸诺龙和左卡尼汀治疗慢性肾衰血液透析病人贫血比促红素常规疗法更有效。     

Treatment of dyskeratosis congenita with Granulocyte Colony-Stimulating Factor and Erythropoietin

Aplastic anaemia is both frequent and difficult to manage in patients with dyskeratosis congenita (DC). We recently treated a 23-year-old male for a year with granulocyte colony-stimulating factor (G-CSF) and erythropoietin (Ep), with an excellent neutrophil response, and a transient effect on haemoglobin levels. G-CSF alone or combined with other cytokines may provide at least a partial effect in pancytopenic patients with DC.     

贫血患者血清红细胞生成素浓度的测定及临床意义

用小鼠胎肝细胞体外血浆凝块培养红系集落(Erythroid colong formig unit inculturc,E-CFUc)方法,以红细胞生成素(Erythropoietin,EPO)850323为标准试剂,测定正常人、贫血病人血清EPO浓度。实验用妊娠13～15d小鼠胎肝细胞。血清均经透析处理,培养液中加量最大不超过10％。EPO(850323)在培养液中浓度为2.5～100mU/ml。血清EPO(mU/ml)测定结果:28例正常人为48.O±17.7,12例再生障碍性贫血病人为946～>10000,1例巨幼细胞性贫血病人为500,1例缺铁性贫血病人为400和18例慢性肾功能衰竭病人则为94.2±87.6。结果表明:贫血病因对血清EPO浓度有影响。     

再生障碍性贫血造血细胞Fas抗原表达与T淋巴细胞功能的研究

目的 研究造血细胞凋亡与T淋巴细胞免疫在再生障碍性贫血(再障，Aplastic anemia，AA)发病机制中的作用及两者相关性。方法 采用流式细胞仪测定40例AA患者和15例非血液、免疫系统疾病对照者骨髓单个核细胞(BMMNC)的总CD34^ 、CD34^ Fas^ 、CD34^ Fas^-、CD3^ 、CD8^ 、CD3^ 、CD3^ CD25^ 标记值。结果 (1)与对照组比较，AA组总CD34^ 细胞％明显减少而其Fas表达率(以占总CD34^ 细胞％为计)明显增高。(2)AA组CD34^ 细胞％数与其Fas抗原表达率无明显负相关。(3)AA组T细胞％明显增多，且以CD8^ 细胞和CD3^ CD25^ 细胞增多为主。(4)AA组CD34^ 细胞％数与其T细胞活化状态无显著负相关。(5)AA组CD34^ 细胞Fas表达率与其T细胞活化状态无显著正相关。结论 AA骨髓存在着造血细胞数量减少和T淋巴细胞亚群数量、功能的异常，造血细胞数量减少还可能与Fas以外途径诱导的凋亡过度有关。骨髓造血细胞凋亡过度可能有活化T淋巴细胞免疫以外的途径诱导Fas途径或活化T淋巴细胞可以通过Fas之外的途径诱导造血细胞凋亡。     

Therapeutic effect of Shenfu Injection on secondary aplastic anemia of tumor patients after chemotherapy

Objective: To explore the effect of Shenfu Injection, SFI) on the secondary aplastic anemia (AA) of tumor patients after chemotherapy (CT).Methods: The 15 cases of SFI treated group, 10 cases of control group, 25 cases of SFI + granulocyte-macrophage colony stimulating factor (GMCSF) treated group and the group of 23 GM-CSF-treated tumor cases of secondary AA after CT were compared, with their increasing rate and the rebound speed of neutrophil, platelet, bone marrow nucleated RBC, granulocyte, and megakaryocyte all being investigated.Results: The increasing rate and rebound speed of granulocyte, platelet, and the increasing rate of bone marrow nucleated RBC, granulocyte, megakaryocyte were obviously higher than those of the control, and the clinical manifestations were also obviously improved. The increasing rate of platelet, bone marrow nucleated RBC, megakaryocyte of the SFI + GM-CSF group were higher than those of the group which used GM-CSF alone, while the increasing rate of granulocyte in blood and bone marrow in both groups was similar.Conclusion: Significant efficacy was shown in SFI for the treatment of secondary AA of tumor patients after CT.     

轻度贫血对学龄儿童体力工作能力的影响

本文报告29对轻度贫血和非贫血儿童在平板机运动试验条件下的最大运动耐受时间,耗氧量、心率和运动后血乳酸浓度。结果表明,轻度贫血组儿童最大耐受时间、最大耗氧量均低于非贫血组。运动后血乳酸高于非贫血组。经一个月补铁治疗后,贫血组最大耐受时间提高0.9分钟,血乳酸降至非贫血组水平,但最大耗氧量无显著性变化。由此说明轻度贫血对学龄儿童体力工作能力有一定的影响。     

用稳定性同位素~(58)Fe中子活化法测定缺铁性贫血儿童膳食铁吸收率

本文报告了应用稳定性同位素~(58)Fe对三组缺铁性贫血儿童,分别摄取平衡膳、平衡膳加大豆蛋白膳和平衡膳加大豆蛋白加维生素C膳时,各组儿童膳食铁的吸收率。测定结果顺次分别为12.0±3.6％、10.7±4.7％和18.1±3.6％。后者高于前二者,差异显著。据此,作者同意国际营养性贫血咨询小组(INACG)以及大多数学者的主张,即大豆制品不利于或降低膳食铁的生物利用率(bioavailability)。本文并结合实验讨论了本法的原理、操作技术及误差控制等问题,评价了本法在类似工作中的重要意义。     

7～12岁儿童铁缺乏及补充对身体做功能力的影响

以１１６０名７～１２岁儿童为研究对象，共筛查出ＩＤＡ儿童２６９人，贫血患病率为２３．１９％。抽取６０名ＩＤＡ儿童分为二组（补铁组、安慰剂组），另选３０名正常儿童为对照组。补铁前后测Ｈｂ、ＦＥＰ、ＰＷＣ１７０、ＲＰＷＣ１７０、ＶＯ２ｍａｘ及血乳酸浓度值。补铁前，ＩＤＡ儿童反映ＰＷＣ大小的各项指标值与正常儿童之间存在显著性差异；经三个月补铁后，补铁组以上各指标值恢复正常水平。结果提示：轻度ＩＤＡ对７～１２岁儿童ＰＷＣ有明显影响，并能通过铁剂治疗得以矫正。