Is there a correlation between raised erythropoietin and thrombotic events in sickle-cell anaemia?
Is there a correlation between raised erythropoietin and thrombotic events in sickle-cell anaemia?
复制标题
镰状细胞性贫血中促红细胞生成素升高与血栓事件之间是否存在相关性？
DOI：
10.1016/s0140-6736(97)11506-9
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
Alberio,L
中科院分区：
文献类型：
--
作者：
Dale,GL;Alberio,L
患有镰状细胞性贫血的儿童容易发生血栓性中风，其病因尚不清楚。我们认为，促红细胞生成素是针对慢性贫血而产生的，是导致血栓增加的血小板反应性改变的原因。这一假设是基于大剂量重组促红细胞生成素治疗的患者中促红细胞生成素驱动的血小板聚集性增强和血栓发生率增加的报道。动物实验表明，促红细胞生成素刺激血小板的合成，与年龄匹配的对照血小板相比，促红细胞生成素驱动的血小板具有高反应性，而且促红细胞生成素是促血栓形成的。这些数据表明，血小板反应性中促红细胞生成素依赖的变化可能会加剧镰状细胞性贫血患者的血栓形成，特别是在儿童中，与成年人相比，他们的促红细胞生成素浓度和中风发生率明显更高。
Children with sickle-cell anaemia are predisposed to thrombotic strokes, the aetiology of which is unclear. We propose that erythropoietin, produced in response to chronic anaemia, is responsible for changes in platelet reactivity with a resulting increase in thromboses. This hypothesis is based on reports of enhanced aggregability of erythropoietin-driven platelets and an increased rate of thrombosis in patients receiving large doses of recombinant erythropoietin. Experiments in animals have shown that erythropoietin stimulates synthesis of platelets, that erythropoietin-driven platelets are hyper-reactive compared with age-matched control platelets, and that erythropoietin is pro-thrombotic. These data suggest that erythropoietin-dependent changes in platelet reactivity may potentiate thrombosis in sickle-cell anaemia, particularly in children who, compared with adults, have markedly higher erythropoietin concentrations and incidence of strokes.