作者参照 Bessler 介绍的胎鼠肝细胞定量测定法测定了75例心衰患者血浆中的促红细胞生成素(EP)的含量。结果显示:心衰组血浆 EP 水平明显高于对照组(P<0.01),其中肺心病组>高心病组>冠心病组,差异有显著性。心功能Ⅲ级与Ⅳ级...作者参照 Bessler 介绍的胎鼠肝细胞定量测定法测定了75例心衰患者血浆中的促红细胞生成素(EP)的含量。结果显示:心衰组血浆 EP 水平明显高于对照组(P<0.01),其中肺心病组>高心病组>冠心病组,差异有显著性。心功能Ⅲ级与Ⅳ级之间无显著性差异,但伴有肾功能不全者 EP 值下降。展开更多
肾性贫血的主要原因是促红细胞生成素的相对不足。此外,潴留的毒性代谢产物抑制骨髓的造血功能即血液中存在红细胞生成抑制因子,红细胞的破坏加速及小量出血亦与肾性贫血的发生有关。尿毒症患者长期食欲不振,营养物质(蛋白质、铁、维生...肾性贫血的主要原因是促红细胞生成素的相对不足。此外,潴留的毒性代谢产物抑制骨髓的造血功能即血液中存在红细胞生成抑制因子,红细胞的破坏加速及小量出血亦与肾性贫血的发生有关。尿毒症患者长期食欲不振,营养物质(蛋白质、铁、维生素及叶酸等)的摄入不足或铝中毒均可使贫血加重。1 促红细胞生成素与肾性贫血肾性贫血治疗的重大进展是应用基因重组技术人工合成促红细胞生成素(recombinant human eryth-ropoietin)(简称促红素)的成功。促红素是一种涎糖蛋白,由165个氨基酸组成多肽,分子量30400。健康人每天合成促红素2～3 u/kg,其中90％以上在肾皮质生成,其余部分由肝脏合成。在肾脏及肝脏中均没有促红素的储备。展开更多
促红细胞生成素(Erythropoitm,EPO)是一种糖蛋白激素,正常条件下在血浆中浓度很低,当贫血或缺氧时,血浆中EPO浓度显著增加,并分泌到尿液里、EPO具有促进红系祖细胞的增殖、分化和成熟的作用,正是这一特性使它在某些贫血治疗中有着重要...促红细胞生成素(Erythropoitm,EPO)是一种糖蛋白激素,正常条件下在血浆中浓度很低,当贫血或缺氧时,血浆中EPO浓度显著增加,并分泌到尿液里、EPO具有促进红系祖细胞的增殖、分化和成熟的作用,正是这一特性使它在某些贫血治疗中有着重要价值。为了研究EPO性状及临床应用,获得大量纯品EPO非常重要,1977年Miyake等人首先经过7步纯化从再障性贫血患者尿中获得毫克量级尿EPO(urme EPO,uEPO)。天然EPO源于正常人及患者尿液、血浆和胎盘浸出液。八十年代后朗编码人EPO基因被克隆,重组人EPO(recombinant human EPO,rhEPO)在哺乳动物细胞中成功表达,大大丰富了EPO来源,减小了纯化难度。展开更多
Second generation thrombopoietin agonists including eltrombopag and romiplostim act on the thrombopoietin receptor to increase the megakaryocyte production. These agents were needed as use of first generation recombin...Second generation thrombopoietin agonists including eltrombopag and romiplostim act on the thrombopoietin receptor to increase the megakaryocyte production. These agents were needed as use of first generation recombinant products was associated with formation of autoantibodies. Eltrombopag is an oral thrombopoietin agonist found effective in raising platelet counts in patients with immune thrombocytopenia. The drug has now been found to be useful in raising platelet counts in thrombocytopenia related to liver disease including cirrhosis and chronic viral hepatitis. Although the drug may help enable adequate interferon therapy in patients with HCV infection and help carry out invasive procedures in patients with cirrhosis, concerns have been raised of possible thrombotic complications including portal vein thrombosis. Randomized trials have shown that use of eltrombopag concomitant with pegylated interferon and ribavirin increased the chances of sustained virologic response while decreasing the dose reductions of interferon. The data on use of romiplostim in these clinical indications is also emerging. However, in the future, availability of interferon free regimens is likely to decrease the use of eltrombopag for enabling antiviral therapy. The review discusses the role of eltrombopag in management of liver disease related thrombocytopenia in wake of recent data as also the dosage, precautions and adverse effects associated with its use.展开更多
文摘肾性贫血的主要原因是促红细胞生成素的相对不足。此外,潴留的毒性代谢产物抑制骨髓的造血功能即血液中存在红细胞生成抑制因子,红细胞的破坏加速及小量出血亦与肾性贫血的发生有关。尿毒症患者长期食欲不振,营养物质(蛋白质、铁、维生素及叶酸等)的摄入不足或铝中毒均可使贫血加重。1 促红细胞生成素与肾性贫血肾性贫血治疗的重大进展是应用基因重组技术人工合成促红细胞生成素(recombinant human eryth-ropoietin)(简称促红素)的成功。促红素是一种涎糖蛋白,由165个氨基酸组成多肽,分子量30400。健康人每天合成促红素2～3 u/kg,其中90％以上在肾皮质生成,其余部分由肝脏合成。在肾脏及肝脏中均没有促红素的储备。
文摘促红细胞生成素(Erythropoitm,EPO)是一种糖蛋白激素,正常条件下在血浆中浓度很低,当贫血或缺氧时,血浆中EPO浓度显著增加,并分泌到尿液里、EPO具有促进红系祖细胞的增殖、分化和成熟的作用,正是这一特性使它在某些贫血治疗中有着重要价值。为了研究EPO性状及临床应用,获得大量纯品EPO非常重要,1977年Miyake等人首先经过7步纯化从再障性贫血患者尿中获得毫克量级尿EPO(urme EPO,uEPO)。天然EPO源于正常人及患者尿液、血浆和胎盘浸出液。八十年代后朗编码人EPO基因被克隆,重组人EPO(recombinant human EPO,rhEPO)在哺乳动物细胞中成功表达,大大丰富了EPO来源,减小了纯化难度。
文摘Second generation thrombopoietin agonists including eltrombopag and romiplostim act on the thrombopoietin receptor to increase the megakaryocyte production. These agents were needed as use of first generation recombinant products was associated with formation of autoantibodies. Eltrombopag is an oral thrombopoietin agonist found effective in raising platelet counts in patients with immune thrombocytopenia. The drug has now been found to be useful in raising platelet counts in thrombocytopenia related to liver disease including cirrhosis and chronic viral hepatitis. Although the drug may help enable adequate interferon therapy in patients with HCV infection and help carry out invasive procedures in patients with cirrhosis, concerns have been raised of possible thrombotic complications including portal vein thrombosis. Randomized trials have shown that use of eltrombopag concomitant with pegylated interferon and ribavirin increased the chances of sustained virologic response while decreasing the dose reductions of interferon. The data on use of romiplostim in these clinical indications is also emerging. However, in the future, availability of interferon free regimens is likely to decrease the use of eltrombopag for enabling antiviral therapy. The review discusses the role of eltrombopag in management of liver disease related thrombocytopenia in wake of recent data as also the dosage, precautions and adverse effects associated with its use.
