肝移植围术期EPO应用的效果及安全性研究(1)
摘 要：目的 評价重组人促红细胞生成素在肝移植围术期中的效果及安全性。方法 回顾分析我院2015年9月～2016年12月原位肝移植89例患者的化验检查、用药情况及围术期输血情况，排除二次肝移植手术患者、死亡患者、术中输血>50 U患者，根据围术期是否应用rHuEPO，分为EPO组和对照组。EPO组入院后根据围术期贫血情况皮下注射 rHuEPO 10000 U/次，1 次/d或1次/2 d;对照组入院后未用rHuEPO。观察两组患者术后血红蛋白、红细胞计数、网织红细胞计数以及输血量的对比情况。结果 ①EPO组患者经治疗后，术后3 d(T1)、术后7 d(T2)、术后15 d(T3)及术后1个月(T4)与术前基础值(T0)比较，Hb变化不大，差异无统计学意义(P>0.05);对照组Hb T1、T2、T3、T4与T0比较明显降低，差异有统计学意义(P<0.01);EPO组T0时点Hb明显低于对照组，差异有统计学意义(P<0.01)，在T3、T4时点Hb高于对照组，差异有统计学意义(P<0.05)。②EPO组患者经治疗后，T1、T2、T3、T4与T0比较，RBC计数差异无统计学意义(P>0.05);对照组RBC T1、T2、T3、T4与T0比较降低，差异有统计学意义(P<0.05);对照组T1、T2、T3、T4时点RBC低于EPO 组，差异有统计学意义(P<0.05)。③EPO组患者经治疗后，网织红细胞计数(RET)T3、T4时点较对照组明显上升，差异有统计学意义(P<0.01); EPO组T3、T4时点与T0比较，RET升高，差异有统计学意义(P<0.01);对照组RET 在 T1、T2、T3、T4与T0比较差异无统计学意义(P>0.05);组间比较，EPO组T3、T4时点RET 明显高于对照组，差异有统计学意义(P<0.01)。结论 肝移植贫血患者在围术期皮下注射rHuEPO，术后1个月患者的贫血改善好于对照组，提示rHuEPO对肝移植贫血的重症患者安全、有效。
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关键词：重组人促红细胞生成素;肝移植;贫血
中图分类号：R656;R619+.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.05.024
文章编号：1006-1959(2018)05-0074-04
Study on the Effect and Safety of EPO in Perioperative Period of Liver Transplantation
JIA Peng-fei1，YUAN Li1，ZHAO Li-peng1，ZANG Yun-jin2，XUE Xin1
(Department of Anesthesiology1，Department of Organ Transplantation2，Affiliated Hospital of Qingdao University，Qingdao 266003，Shandong，China)
, 百拇医药
Abstract：Objective To evaluate the effect and safety of recombinant human erythropoietin(RH)in the perioperative period of liver transplantation.Methods 89 cases of orthotopic liver transplantation from September 2015 to December 2016 in our hospital were retrospectively analyzed，including laboratory examination，drug use and perioperative blood transfusion，excluding secondary liver transplantation patients，dead patients，and patients with intraoperative blood transfusion>50 U.According to whether or not to use rHuEPO during perioperative period，the EPO group and control group.Group EPO was subcutaneously injected with rHuEPO 10000 U/，1 times/d or 1/2 d，and the control group did not use rHuEPO after admission.The comparison of hemoglobin，red blood cell count， reticulocyte count and blood transfusion after operation was observed in the two groups.Results EPO group of patients after treatment， postoperative 3 d(T1)，7 d after operation(T2)，15 d after operation(T3)and 1 months after surgery(T4)with preoperative value(T0)，Hb changed little，there was no statistically significant difference(P>0.05)the control group Hb;T1，T2，T3，T4 and T0 significantly decreased， the difference was statistically significant(P<0.01);EPO group at T0 Hb was significantly lower than the control group，the difference was statistically significant(P<0.01)，in T3，T4 at Hb was higher than the control group，the difference was statistically significant(P< 0.05).②EPO group of patients after treatment，T1，T2，T3，T4 and T0，there was no significant difference between RBC count(P>0.05);the control group RBC T1，T2，T3，T4 and T0 decreased，the difference was statistically significant(P<0.05);control group T1，T2，T3，T4 at RBC lower than the EPO group，the difference was statistically significant(P<0.05).③After treatment，the time of reticulocyte count (RET)T3 and T4 in group EPO was significantly higher than that in the control group(P<0.01).Compared with T0 in EPO group，there was a statistically significant increase in RET and RET(P<0.01).There was no significant difference in RET，T1，T2，T3 and T4 between the control group and T0 group(P>0.05).In group comparison，the time point of T3 and T4 in group EPO was significantly higher than that in the control group，and the difference was statistically significant(P<0.01).Conclusion The hypodermic injection of rHuEPO in perioperative period is better than that in the control group at 1 month after operation.It indicates that rHuEPO is safe and effective for severe patients with anemia after liver transplantation., 百拇医药(贾鹏飞 袁莉 赵利鹏 臧运金 薛欣)
, http://www.100md.com
关键词：重组人促红细胞生成素;肝移植;贫血
中图分类号：R656;R619+.1 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.05.024
文章编号：1006-1959(2018)05-0074-04
Study on the Effect and Safety of EPO in Perioperative Period of Liver Transplantation
JIA Peng-fei1，YUAN Li1，ZHAO Li-peng1，ZANG Yun-jin2，XUE Xin1
(Department of Anesthesiology1，Department of Organ Transplantation2，Affiliated Hospital of Qingdao University，Qingdao 266003，Shandong，China)
, 百拇医药
Abstract：Objective To evaluate the effect and safety of recombinant human erythropoietin(RH)in the perioperative period of liver transplantation.Methods 89 cases of orthotopic liver transplantation from September 2015 to December 2016 in our hospital were retrospectively analyzed，including laboratory examination，drug use and perioperative blood transfusion，excluding secondary liver transplantation patients，dead patients，and patients with intraoperative blood transfusion>50 U.According to whether or not to use rHuEPO during perioperative period，the EPO group and control group.Group EPO was subcutaneously injected with rHuEPO 10000 U/，1 times/d or 1/2 d，and the control group did not use rHuEPO after admission.The comparison of hemoglobin，red blood cell count， reticulocyte count and blood transfusion after operation was observed in the two groups.Results EPO group of patients after treatment， postoperative 3 d(T1)，7 d after operation(T2)，15 d after operation(T3)and 1 months after surgery(T4)with preoperative value(T0)，Hb changed little，there was no statistically significant difference(P>0.05)the control group Hb;T1，T2，T3，T4 and T0 significantly decreased， the difference was statistically significant(P<0.01);EPO group at T0 Hb was significantly lower than the control group，the difference was statistically significant(P<0.01)，in T3，T4 at Hb was higher than the control group，the difference was statistically significant(P< 0.05).②EPO group of patients after treatment，T1，T2，T3，T4 and T0，there was no significant difference between RBC count(P>0.05);the control group RBC T1，T2，T3，T4 and T0 decreased，the difference was statistically significant(P<0.05);control group T1，T2，T3，T4 at RBC lower than the EPO group，the difference was statistically significant(P<0.05).③After treatment，the time of reticulocyte count (RET)T3 and T4 in group EPO was significantly higher than that in the control group(P<0.01).Compared with T0 in EPO group，there was a statistically significant increase in RET and RET(P<0.01).There was no significant difference in RET，T1，T2，T3 and T4 between the control group and T0 group(P>0.05).In group comparison，the time point of T3 and T4 in group EPO was significantly higher than that in the control group，and the difference was statistically significant(P<0.01).Conclusion The hypodermic injection of rHuEPO in perioperative period is better than that in the control group at 1 month after operation.It indicates that rHuEPO is safe and effective for severe patients with anemia after liver transplantation., 百拇医药(贾鹏飞 袁莉 赵利鹏 臧运金 薛欣)