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Objective To systematically review the clinical efficacy and safety of early use of recombinant human erythropoietin (rHu-EPO) for neuroprotection in premature infants.Method From establishment of the databases to November 2017,clinical randomized controlled trials (RCTs) of early use of rHu-EPO in premature infants were searched on English databases (PubMed,Embase,Cochrane Collaboration) and Chinese databases (CNKI,SinoMed,Wanfang,and VIP Database).Patients receiving conventional therapy were assigned into control group,and patients receiving both conventional therapy and rHu-EPO were assigned into rHu-EPO group.rHu-EPO group was subdivided into high-dose continuous group and low-dose intermittent group.We retrieved the related literatures,evaluated the quality,and then performed Meta-analysis using RevMan 5.3 software.Result A total of 2 588 patients in 17 studies were included and analyzed.Compared with the control group,Meta-analysis showed that early use of rHu-EPO was more effective in improving NBNA scores at 40 weeks of corrected gestational age (cGA) (MD=2.46,95％CI 1.58～3.33,P＜0.001),and high-dose continuous group was better than low-dose intermittent group (MD=3.19,95％CI 0.45～5.93,P=0.002;MD=2.22,95％CI 1.29～3.16,P＜0.001).Low-dose intermittent use of rHu-EPO significantly increased mental development index (MDI) (MD=6.66,95％CI 0.80～12.51,P=0.010) and psychomotor development index (PDI) (MD=5.77,95％CI 4.00～7.55,P＜0.001),and reduced the incidence of MDI＜70 at cGA 18～22 months (OR=0.42,95％CI 0.27～0.67,P＜0.001).As to the safety and side effects,treatment with rHu-EPO reduced the risk of necrotizing enterocolitis (OR=0.48,95％CI 0.31 ～0.72,P＜0.001) and periventricular leukomalacia (OR=0.52,95％CI 0.35～0.75,P＜0.001)without increasing the risk of bronchial dysplasia,patent ductus arteriosus,retinopathy in prematurity and intraventricular hemorrhage.Conclusion Current evidence shows that the early use of rHu-EPO in premature infants is relatively effective and safe,but multi-center RCTs are still needed.
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Objective To investigate the effects of recombinant human erythropoietin (rhEPO) on the expression of vascular endothelial growth factor (VEGF) protein and mRNA in lung tissue of premature rat model of the new type bronchopulmonary dysplasia (BPD).Methods Lipopolysaccharide (LPS) or PBS was injected into 60 pregnant rats on the 15th day of gestation.The premature rats by cesarean delivery on the 21th day of gestation were divided into 5 groups:PBS+ air group,PBS+ hyperoxia group,LPS+hyperoxia group,PBS+hyperoxia+rhEPO group,LPS+hyperoxia+rhEPO group.In rhEPO intervention groups,after 6 h exposure to hyperoxia,rhEPO (1 200 IU/kg) was administrated subcutaneously,once every other day for 7 times.The survival rate,body weight,lung weight and lung weight/body weight ratio and pathological changes of lung tissue were observed,the expression levels of VEGF protein and mRNA in the lung tissue were determined by Western blot and RT-PCR at the 1st,7th and 14th day after hyperoxia exposure.Results Compared with the PBS+air group,the survival rate and body weight were decreased,the lung weight was increased,the lung pathological damages were more serious,the expression levels of VEGF protein and mRNA in lung tissue were decreased after hyperoxia exposure.These changes were more notable in the LPS+hyperoxia group (P＜0.05).The lung weight/body weight ratio showed an increasing tendency (P＞0.05).The above indexes were improved after rhEPO intervention (P＜0.05).Conclusion rhEPO could increase the survival rate and produce certain intervention and treatment effects by regulating the VEGF relative pathway in BPD model rats.
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Objective To investigate the effects of recombinant human erythropoietin (rhEPO) on the expression of vascular endothelial growth factor (VEGF) protein and mRNA in lung tissue of premature rat model of the new type bronchopulmonary dysplasia (BPD).Methods Lipopolysaccharide (LPS) or PBS was injected into 60 pregnant rats on the 15th day of gestation.The premature rats by cesarean delivery on the 21th day of gestation were divided into 5 groups:PBS+ air group,PBS+ hyperoxia group,LPS+hyperoxia group,PBS+hyperoxia+rhEPO group,LPS+hyperoxia+rhEPO group.In rhEPO intervention groups,after 6 h exposure to hyperoxia,rhEPO (1 200 IU/kg) was administrated subcutaneously,once every other day for 7 times.The survival rate,body weight,lung weight and lung weight/body weight ratio and pathological changes of lung tissue were observed,the expression levels of VEGF protein and mRNA in the lung tissue were determined by Western blot and RT-PCR at the 1st,7th and 14th day after hyperoxia exposure.Results Compared with the PBS+air group,the survival rate and body weight were decreased,the lung weight was increased,the lung pathological damages were more serious,the expression levels of VEGF protein and mRNA in lung tissue were decreased after hyperoxia exposure.These changes were more notable in the LPS+hyperoxia group (P＜0.05).The lung weight/body weight ratio showed an increasing tendency (P＞0.05).The above indexes were improved after rhEPO intervention (P＜0.05).Conclusion rhEPO could increase the survival rate and produce certain intervention and treatment effects by regulating the VEGF relative pathway in BPD model rats.
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Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on brain injury in the patients undergoing cardiac valve replacement with cardiopulmonary bypass (CPB).Methods Forty-five patients with chronic valvular heart disease,aged 36-62 yr,weighing 42-92 kg,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,with New York Heart Association of Ⅱ or Ⅲ,undergoing cardiac valve replacement with CPB,were randomly divided into 3 groups (n =15 each) using a random number table:control group (group C),and different doses of rHuEPO groups (EPO1 group,EPO2 group).In EPO1 and EPO2 groups,rHuEPO 40 and 80 IU/kg were injected intravenously before anesthesia induction,respectively.Before anesthesia induction (T0,baseline value),immediately after endotracheal intubation (T1),immediately after aortic cannulation (T2),immediately after cannulation of superior and inferior vena cava (T3),immediately after the beginning of CPB (T4),when each index was decreased to the minimal value during CPB (T5),after rewarming to 36.5 ℃ (T6),immediately after termination of CPB (T7),and at 1 h after termination of CPB (T8),regional cerebral oxygen saturation (rSO2),tissue hemoglobin index (THI),and changes in concentrations of oxyhemoglobin (△ O2Hb),deoxyhemoglobin (△ HHb) and total hemoglobin (△ cHb) in bilateral frontal lobes were recorded.The patients whose minimal rSO2 ≤ 50％ and decrease in minimal rSO2 ≥ 20％ of the baseline value (△rSO2) were recorded.At T0,T8 and 2 h after termination of CPB (T9),venous blood samples were taken for determination of serum concentrations of S100 protein and neuron-specific enolase (NSE) by ELISA.At 1 day before surgery and 8 days after surgery,the patient's cognitive function was assessed using Mini-Mental State Examination,the Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R),the Digit Symbol subtest of the WAIS-R,the Trailing Making Test (Part A)and the Stroop Color Word Interference Test,while depression and anxiety were assessed by Zung Self-Rating Depression Scale and Zung Self-Rating Anxiety Scale,respectively.The occurrence of postoperative cognitive dysfunction was recorded.Results There was no significant difference among the three groups in bilateral rSO2 and △ cHb,incidence of bilateral rSO2 ≤ 50％ and postoperative cognitive dysfunction,Zung Self-Rating Depression Scale score,and Zung Self-Rating anxiety Scale score at each time point (P＞0.05).Compared with group C,the incidence of left △ rSO2 ≥ 20％ was significantly decreased,the right △ O2 Hb was increased at T6,8,the serum NSE concentrations were decreased at T9,the serum S100 protein concentrations were decreased at T8,and the number of the Digit Symbol subtest of the WAIS-R completed was increased in group EPO1,and right THI was significantly decreased at T2,T3,T5,T7 and T8,right △ HHb was increased at T2 and T3,and the completion time of Stroop color word interference test B was shortened at 8 days after surgery in group EPO2 (P＜0.05 or 0.01).Compared with group EPO1,the incidence of left △rSO2 ≥ 20％ was significantly increased,the right THI was decreased at T2-4 and T6-8,and the left △ O2 Hb at T6-7 and right △ O2 Hb at T8 were decreased in group EPO2 (P＜0.05).Conclusion rHuEPO 40 IU/kg injected intravenously before induction of anesthesia can mitigate brain injury in the patients undergoing cardiac valve replacement with CPB.
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Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on lung injury induced by hepatic ischemia-reperfusion (I/R) in rats.Methods Sixty healthy male SpragueDawley rats, aged 6-8 weeks, weighing 220-280 g, were randomly divided into 3 groups (n=20 each) using a random number table: sham operation group (group S) , hepatic I/R group (group I/R), and rHuEPO group (group E).I/R and E groups underwent I/R of 70 percent of the liver.The rHuEPO 4 000 U/kg was injected intraperitoneally at 24 h before I/R in group E, while the equal volume of normal saline was given in S and I/R groups.The rats were sacrificed at 3 h of reperfusion, and lungs were removed and cut into sections which were stained with haematoxylin and eosin and examined under light microscope.Wet to dry lung weight ratio (W/D ratio) was calculated.The expression of heme oxygenase-1 (HO-1) and inducible nitric oxide synthase (iNOS) in lung tissues was determined by immunohistochemistry.The content of malondialdehyde (MDA), and activities of superoxide dismutase (SOD) and myeloperoxidase (MPO) in lung tissues were detected.Results Compared with group S, the W/D ratio, MDA content, and MPO activity were significantly increased, the SOD activity was decreased, the expression of HO-1 and iNOS was up-regulated (P＜0.05) , and the pathological changes of lung tissues were obvious in E and I/R groups.Compared with group I/R, the W/D ratio, MDA content, and MPO activity were significantly decreased, the SOD activity was increased, the expression of HO-1 was up-regulated, the expression of iNOS was down-regulated (P＜0.05) , and the pathological changes of lung tissues were reduced in group E.Conclusion The rHuEPO can alleviate hepatic I/R-induced lung injury in rats, and the mechanism may be related to up-regulated expression of HO-1 and down-regulated expression of iNOS.
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Objective To study the effects of erythropoietin (rhEPO) in high glucose induced proliferation and apopto?sis of human kidney proximal tubular epithelial (HK-2) cells, and the possible mechanism thereof. Methods HK-2 cells cultured in vitro were divided into several groups randomly:blank control group, high glucose group, mannitol group, rhEPO control group, different concentrations of rhEPO treatment groups (5, 10, 20 U/mL) and Rho kinase group. The reverse tran?scription polymerase chain reaction (RT-PCR) was used to evaluate the mRNA levels of RhoA and ROCK after 24 hours. Tetrazolium salt method (MTT) was used to determine the cell proliferation. Cell apoptosis was detected by flow cytometry. Results Compared with blank control group the expression levels of RhoA and ROCK1 mRNA were significantly in?creased in high glucose group (P < 0.05). RhoA, ROCK1 mRNA expressions significantly decreased in rhEPO group than those of high glucose group (P<0.05). There was a positive correlation between the expression levels of RhoA mRNA and ROCK1 mRNA in high glucose group and rhEPO group. MTT method showed that rhEPO significantly promoted the prolifer?ation of HK-2 cells (P<0.05). Flow cytometry analysis showed that high glucose induced apoptosis in HK-2 cells, which was significantly inhibited in rhEPO group and Rho kinase group as compared to that of high glucose group in a concentra?tion dependent manner (P<0.05). Conclusion rhEPO can promote HK-2 cell proliferation and inhibit apoptosis, which may be related to RhoA/ROCK signaling pathway.
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Erythropoietin (EPO) is an active glycoprotein synthesized by kidney. The physiological function of regulat?ing the synthesis of erythrocytes by EPO makes it as a clinical drug for treatment of anemia resulted from chronic kidney fail?ure. However, its short biological half-life makes frequent administration, which limits its wide clinical utility since the tough burden and pain on patients. Therefore, the development of EPO derivatives with good efficacy, less adverse reaction and long duration has been a hot spot in the field during several decades. There are currently many different variants of EPO derivatives including erythropoiesis stimulating agents (ESAs) on the market. This article aims to summarize the recent re?search progress in the development of erythropoietin derivatives, specially focusing on EPO mimetic peptides (EMP).
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Objective:To observe clinical therapeutic effect of recombinant human erythropoietin (rhEPO)on pa-tients with heart failure complicated chronic kidney disease.Methods:A total of 84 patients with heart failure com-plicated renal insufficiency were selected.They were divided into routine treatment group (n=42)and rhEPO group (n=42,received rhEPO based on routine treatment)according to random number table method.Echocardiographic examination results and renal function were compared between two groups after 12-week treatment.Results:Com-pared with routine treatment group,there were significant rise in left ventricular ejection fraction [LVEF,(37.2± 10.3)% vs.(45.4 ± 11.4)%]and left ventricular fractional shortening [LVFS,(19.6 ± 4.3)% vs.(24.5 ± 3.8)%],and significant reductions in left ventricular end-diastolic diameter [LVEDd,(6.12±0.67)mm vs.(5.01 ±0.54)mm],24h urinary protein [(0.76±0.1)g vs.(0.24±0.09)g],24h urine microalbumin [(319.6±39.6) mg vs.(107.3±26.7)mg],blood urea nitrogen [(10.3±1.9)mmol/L vs.(6.2±1.5)mmol/L]and serum creati-nine [(97.2±16.8)μmol/L vs.(79.3±15.7)μmol/L]in rhEPO group,P<0.01 all.Conclusion:Recombinant human erythropoietin could significantly improve heart,renal function in patients with heart failure complicated re-nal insufficiency.
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Objective To investigate the myocardial protective effects ,mechanism and safety of recombinant human erythropoie-tin(rHuEPO) pretreatment in the patients undergoing cardiac surgery with cardiopulmonary bypass (CPB) .Methods Thirty pa-tients with rheumatic heart disease undergoing valve replacement surgery were randomly divided into the observation group and the control group ,15 cases in each group .The observation group was given rHuEPO 300IU/kg by hypodermic injection on preoperative 2 d ,once daily for twice .The control group was given the same dose of normal saline .The blood routine was performed before sur-geryandonpostoperative7d.Thelevelsofcreatinekinaseisoenzyme(CK-MB)andtroponinT(cTnT)weredetectedbeforeopera-tion ,at 6 ,24 ,72 h after the aorta opening (T0 ,T6 ,T24 ,T72 ) .At the end of CPB ,myocardial biopsy was conducted for detecting the myocardial apoptosis index (AI) .The CPB time ,aortic cross clamp(ACC) time ,postoperative ICU stay ,blood transfusion and post-operative complications were recorded .Results The level of postoperative CK-MB and cTnT in the two groups were significantly increased after the aorta opening ,which at T6 was highest ,followed by a downward trend .The levels of CK-MB and cTnT at vari-ous time points in the observation group were significantly lower than those in the control group .The main effect of rHuEPO pre-treatment had statistical difference between the two groups (P= 0 .01) .Myocardial AI in the observation group was significantly lower than that in the control group ,the difference showing statistical significance (P<0 .01) .The observation group had no risk leading to obviously increase postoperative Hb ,Hct values and thromboembolism ,but the postoperative blood transfusion amount was reduced .Conclusion rHuEPO pretreatment has the protective effect on myocardium in the patients undergoing cardiac surgery under CPB ,which can reduce myocardial apoptosis and has safe reliability .
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Objective To investigate the effects of recombinant human erythropoietin(rhEPO)on expressions of tumon necrosis factor-alpha(TNF-α) and inter leukin-6(IL-6) in rats after focal cerebral ischemia and to explore its neuroprotective mechanism.Methods A total of 36 healthy male SD rats were randomly divided into sham-operated group (n=12),model group (n=12) and rhEPO treatment group (n=12).The suture method to make permanent middle cerebral artery occlusion model was adopted.rhEPO treatment group was injected with rhEPO 5000 U/kg intraperitoneally after 2 h of ischemia,whereas model group and sham-operated group were given identical saline at the same time.All rats were decapitated after 24 h of ischemia.6 rats were randomly selected in each group and the infarct volume of groups were measured by Triphenyl tetrazolium chloride (TTC)staining method.The expressions of TNF-α,IL-6 in other rats were detected by immunohistochemistry.Results No infarction was found in sham-operated group.Percentage of infarct volume in model group and rhEPO group were (36.672.40)％ and (27.49± 1.47)％,respectively.Compared with the model group,the volume of infarction in rhEPO group was significantly reduced.Cells stained by immunohistochemistry showed that The numbers of TNF-α-positive cells in the 3 groups were 9.001.41,27.83±2.48,17.50±1.87 and IL 6 positive cells were 8.94±2.31,20.33±3.53,14.83±1.70,respectively.Compared with sham operated group,the expressions of TNF-α and IL 6 in model group were significantly increased (q=16.1,19.6,P＜0.01).Compared with the model group,the expressions of TNF α and IL-6 in rhEPO group were significantly decreased (q=8.19,3.44,all P＜0.01).Conclusions rhEPO can decrease the infarct volume in SD rats after acute focal cerebral ischemic injure.rhEPO might exert its neuroprotective effect by reducing the expressions of TNF α and IL-6.
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Objective To investigate the clinical efficiency and security of Fe(OH) 3-sncrose-compond combined with erythropoietin on renal anemia.Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis,the cases were randomly divided into two groups:the treatment group(n =16) using intravenous sucrose iron 100mg,twice a week,after a total of 1000mg,then l00mg,once 1 -2 weeks;the control group(n =14) continue to oral:ferrous succinate 0.2g,three times everyday,erythropoietin dose was the same in lothgroups for g weeks.Results Hemoglobin was significantly higher(P ＜ 0.01) and hematocrit was significantly higher(P ＜0.01),and serum ferritin significant increased(P ＜0.0l) in sucrose iron treatment group than these of the control group;the patients of treatment group have obviously improved in spirit,appetite,physical and life quality and so on.Sometimes,nausea,vomiting,skin itching were complained lut without significant side effects.While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort,poor appetite.Conclusion The efficiency of intravenous sucmfer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.
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ObjectiveTo evaluate the effect and safety of recombinant human erythropoietin (rhEPO) in treatment of lung cancer chemotherapy-related anemia.MethodsNinety-eight lung cancer chemotherapy-related anemia patients were divided into treatment group and control group with 49 cases each by random digits table method.The patients in treatment group were given rhEPO and chalybeate.The patients in control group were merely given chalybeate.The hemoglobin (Hb),hematocrit,allogeneic blood transfusion rate and quality of life between two groups were observed and compared.ResultsThree cases were rejected in treatment group,and 3 cases with anergy and dizzy and 2 cases with local injection site pain and sclerosis recovered spontaneously.Hb and hematocrit showed downward trend after treatment in control group,but there was no significant differences (P ＞ 0.05).Hb and hematocfit had upgrade trend after treatment in treatment group,and there were significant differences between after 4 - 8 months treatment and before treatment (P ＜ 0.05 ).The allogeneic blood transfusion rate was 24.5％ (12/49) in control group and 6.5％ (3/46) in treatment group,and there was significant difference between two groups (P ＜ 0.05 ).The quality of life in treatment group was increased compared with that in control group.There were significant differences in the effective rate after 4 or 8 weeks treatment between two groups [52.2％(24/46) vs.6.1％(3/49) and 95.7％ (44/46) vs.20.4％ ( 10/49 )].ConclusionsrhEPO is effective and safe in treatment of lung cancer chemotherapy-related anemia.rhEPO has little adverse reaction and can improve the quality of life.
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Objective To study the role of PI3K-Akt-GSK-3β signaling in the apoptosis of renal tubular cells after ischemia-reperfusion injury and the protective mechanism of recombinant human erythropoietin(rHuEPO). Methods The human kidney tubular epithelial cells(HK-2)were cultured in vitro in different conditions as control group with serum, ischemia-reperfusion(IR)group, LY294002 group with LY294002(AKT inhibitor)10 μmol/L 30 minutes before IR treatment, LiCl group with LiCl(GSK-33 inhibitor)20 μtmol/L 30 minutes before IR treatment, rHuKPO group with EPO 20 U/ml 30 minutes before IR treatment, rHuEPO + LY294002 group with EPO 20 U/ml and in the presence of LY294002(10 μmol/L)30 minutes before IR treatment, rHuEPO +LiCl group with EPO 20 U/ml and in the presence of LiCl(20 μmol/L)30 minutes before IR treatment. Akt, GSK-33 and caspase-3 activation were measured by Western blotting. The apoptotic ratio of HK-2 cells was measured by flow cytometry. Cell viability was detected by MTT. Results In comparison with the control group, the apoptotic ratio raised up to 15.20%±1.43%, the expression of Akt activity decreased, GSK-33 activity and caspase-3 activity markedly elevated in IR group(P<0.05). LY294002 group up-regulated the apoptotic ratio(18.20%±2.06%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, however, LiCl group down-regulated the apoptotic ratio(12.30%±0.85%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO group remarkably decreased the apoptotic ratio(11.10%±1.62%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with IR group(P<0.05). rHuEPO+LY294002 group elevated the apoptotic ratio(13.40%±1.94%), decreased the expression of Akt activity, increased GSK-33 activity and caspase-3 activity, meanwhile, rHuEPO +LiCl group down-regulated the apoptotic ratio(7.50%±1.31%), increased the expression of Akt activity, decreased GSK-33 activity and caspase-3 activity compared with rHuEPO group(P<0.05). Conclusions PI3K-Akt-GSK-3β signaling pathway is involved in HK-2 cells apoptosis induced by ischemia-reperfusion injury and rHuEPO may be used as a new therapy.
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Anti-erythropoietin antibodies usually cross-react with all kinds of recombinant erythropoietins; therefore, erythropoiesis-stimulating agent (ESA)-induced pure red-cell aplasia (PRCA) is not rescued by different ESAs. Here, we present a case of ESA-induced PRCA in a 36-yr-old woman with chronic kidney disease, whose anemic condition improved following reintroduction of darbepoetin-alpha. The patient developed progressive, severe anemia after the use of erythropoietin-alpha. As the anemia did not improve after the administration of either other erythropoietin-alpha products or erythropoietin-beta, all ESAs were discontinued. Oxymetholone therapy failed to improve the transfusion-dependent anemia and a rechallenge with ESAs continuously failed to obtain a sustained response. However, her anemia improved following reintroduction of darbepoetin-alpha at 3 yr after the initial diagnosis. Interestingly, anti-erythropoietin antibodies were still detectable, although their concentration was too low for titration. In conclusion, darbepoetin-alpha can improve ESA-induced PRCA when the anti-erythropoietin antibody titer declines and its neutralizing capacity is lost.
Subject(s)
Adult , Female , Humans , Anemia/drug therapy , Antibodies/blood , Bone Marrow Cells/pathology , Drug Hypersensitivity/immunology , Erythropoietin/analogs & derivatives , Erythropoietin/adverse effects , Glomerulonephritis, IGA/complications , Hematinics/adverse effects , Kidney Failure, Chronic/complications , Oxymetholone/therapeutic use , Red-Cell Aplasia, Pure/chemically inducedABSTRACT
Objective To study the effects of recombinant human erythropoietin(r-HuEPO) on RBC immunity in chronic renal failure(CRF) patients.Methods Forty-five CRF patients were divided into two groups : 20 patients without r-HuEPO(control group) and 25 patients with r-HuEPO more than one month(experimental group).The RBC-C_(3b)RR and RBC-ICRR in two groups were counted under microscope and the correlations between HB or CRE and RBC-C_(3b)RR were calculated.Results The concentrationd of Hb,RBC-C_(3b)RR in experimental group were much higher than those in control group(P
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Objective To study the effect of recombinant human erythropoietin (rHuEPO) on in aged patients undergoing maintenance hemodialysis. Methods Blood pressure and its mechanism 52 elderly patients undergoing maintenance hemodialysis divided into two groups, HBP group (23 cases with hypertension) and NBP group(29 cases without hypertension). The plasma vasoactive substances were measured by radioimmunological methods. Fifteen cases in NBP group as EPO group were given a bolus of venous injection of rHuEPO (3 000 IU), others in NBP group (14 cases) were injected 0.9% saline as control group. The plasma vasoactive substances were assayed before and 1, 3, 6, 9, 12, 18, 24, 30, 44 hours after therapy with or without rHuEPO. Results (1) The plasma dopamine (DA) in HBP group were significantly higher than that of NBP group. (2) Endothelin levels increased transiently but DA levels increased steadily in EPO group. Conclusions The study suggests that the effect of rHuEPO induced on hypertension in the elderly patients undergoing maintenance hemodialysis is associated with the increasing plasma DA.
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Objective To investigate the efficacy of recombinant human erythropoietin(rHuEPO) in treating the anemia in obstrics. Methods 40 antepartum anemia patients and 36 postpartum anemia patients were treated with rHuEPO 8000IU intravenously. Another 40 antepartum and 36 postpartum anemia patients were selected as control. Oral supplementation of iron and folic acid were used both in study and control group. Results The hemoglobin level was increased significantly in the study group than control group both in the prenatal and postpartum anemia patients. ( P0.05 )。 Conclusion rHuEPO therapy for obstetric anemia is effective and safe.
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Objective To assess the preventive effects of recombinant human erythropoietin (rHu EPO) on the anemia of premature birth infant. To determine whether prophylactic treatment with rHu EPO and iron would reduce the postnatal hemoglobin (Hb) decline and blood transfusion of premature infants. Methods Fifty one infants of less than 35 weeks of gestation and 2000 g of birth weight from multicenter were randomly assigned to EPO group ( n =31) and control group ( n =20). Infants in EPO group received rHuEPO 250 IU/(kg?t) intravenously or subcutaneously once every second day, started between 2 and 10 days of age, maintained for 4 weeks. Oral iron and vitamin E supplements were given to all infants. Hb, hematocrit (Hct), reticulocyte counts (Ret), serum iron and erythropoietin (EPO) were detected in both groups. Results Postnatal decline of Hb and Hct were less in EPO group than that in the control group at the end of study (129.9?21.0 vs 103.2?14.3, P
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Objective To assess the efficacy and the optimum dose of recombinant human ery- thropoietin(rhEpo) in the treatment of the anemia of premature.Methods 40 preterm infants with less than 35 weeks of gestational age and less than 2000gin of birth weight were randomly assigned to receive subcutaneous rhEpo 150U?kg~(-1)?t~(-1)(n=10) 250U?kg~(-1)?t~(-1)(n=15),three times weekly for 6 weeks,or no treatment(control,n=15).Results Postnatal decline of hemoglobin(Hb) and hematocrit (Hct) were lessened in the treated groups,particularly in the rhEpo 250U?kg~(-1)?t~(-1)group; and there were significant differences in each groups by analysis of variance(all P0.05).Serum iron dropped,more significantly in the treated groups than in control group (all P0.05).After treatment,serum levels of erythropoietin was higher in rhEpo 250U?kg~(-1), t~(-1) group than in both rhEpo 150U?kg~(-1)?t~(-1) and control groups (P0.05).No side effects related to rhEpo therapy were observed.Conclusious RhEpo therapy for premature infants is effective and dose-dependent.Therapy is more efficient when given in high dose.It can reduce or replace the need for blood transfusion.
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Objective To evaluate the effect of recombinant human erythropoietin (rHuEPO) on anemia and blood transfusion requirements in perioperative patients.Methods21 cases, with abdominal surgery(with anemia before operation or with expected blood loss 400～600?ml were divided into two groups (study group or control group).The patients in the study group received subcutaneously rHuEPO 300?IU?kg -1 ?w -1 starting 2 weeks before operation for 3 times.Results In the study group,RBC,Hgb,Hct significantly increased to 0 36?10 12 /L?13 3?g/L and 3 8% respectively after rHuEPO therapy,intraoperative blood transfusion reduced significantly ( P