TREATMENT OF ORTHOSTATIC HYPOTENSION WITH ERYTHROPOIETIN
TREATMENT OF ORTHOSTATIC HYPOTENSION WITH ERYTHROPOIETIN
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DOI：
10.1056/nejm199308263290904
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发表时间：
1993-08-26
影响因子：
158.5
通讯作者：
STREETEN, DHP
中科院分区：
文献类型：
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作者：
HOELDTKE, RD;STREETEN, DHP
背景和方法。由自主神经病变引起的直立性低血压患者经常出现红细胞量减少。预计这会损害其有效循环血量并加剧体位性低血压。我们对 8 名直立性低血压患者（4 名男性、1 名十几岁男孩和 3 名女性（年龄范围为 17 至 68 岁））研究了促红细胞生成素增加红细胞质量的效果，皮下注射剂量为每公斤体重 50 U，每周 3 次，持续 6 至 10 周。 4 名患者患有 I 型糖尿病和自主神经病变，3 名患者患有单纯自主神经衰竭，1 名患者患有交感神经性直立性低血压。七名患者在促红细胞生成素试验之前、期间和之后接受了氟氢可的松（每天 0.1 或 0.2 毫克）。治疗前后测量红细胞体积、血浆体积和对直立应激的血流动力学反应。结果。促红细胞生成素将平均 (+/-SD) 血细胞比容从 0.34+/-0.04 增加至 0.45+/-0.04 (P
Background and Methods. Patients with orthostatic hypotension caused by autonomic neuropathy frequently have a decreased red-cell mass. This would be expected to compromise their effective circulating blood volume and aggravate the orthostatic hypotension. We studied the effect of increasing the red-cell mass with erythropoietin, given subcutaneously in a dose of 50 U per kilogram of body weight three times a week for 6 to 10 weeks to eight patients with orthostatic hypotension - four men, one teenage boy, and three women (age range, 17 to 68 years). Four patients had type I diabetes mellitus and autonomic neuropathy, three patients had pure autonomic failure, and one patient had sympathotonic orthostatic hypotension. Seven patients received fludrocortisone (0.1 or 0.2 mg per day) before, during, and after the trial of erythropoietin. The red-cell volume, plasma volume, and hemodynamic response to orthostatic stress were measured before and after therapy.Results. Erythropoietin increased the mean (+/-SD) hematocrit from 0.34+/-0.04 to 0.45+/-0.04 (P