Marked erythrocyte microcytosis under primary immunosuppression with sirolimus
Marked erythrocyte microcytosis under primary immunosuppression with sirolimus
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DOI：
10.1111/j.1432-2277.2005.00190.x
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发表时间：
2006-01-01
影响因子：
3.1
通讯作者：
Dickenmann, M
中科院分区：
文献类型：
--
作者：
Kim, MJ;Mayr, M;Dickenmann, M
作为一项比较西罗莫司（SRL）和环孢素a （CsA）作为初级免疫抑制剂的前瞻性研究的一部分，研究人员对西罗莫司（SRL）和霉酚酸酯（MMF）治疗的患者中明显的红细胞微胞症进行了初步观察。正常风险新生肾受者随机分为SRL组和CsA组。额外的免疫抑制剂包括MMF和强的松。在红细胞微胞症患者中，通过测定血清铁蛋白和转铁蛋白饱和度排除缺铁。纳入59例患者（SRL 30例，CsA 29例）。移植后第7天，SRL组的平均红细胞体积（MCV）为91.7 +/- 4.8，CsA组为91.4 +/- 4.2 (P = 0.77)；移植后第183天，SRL组的平均MCV为78.5 +/- 3.8，CsA组为88.4 +/- 3.4 （P < 0.0001）。血红蛋白浓度（g/dl）差异无统计学意义。SRL组只有2例患者出现转铁蛋白饱和率下降。在接受SRL和MMF治疗的患者中观察到明显的红细胞小细胞增多而无持续性贫血。
The preliminary observation of marked erythrocyte microcytosis in patients treated with sirolimus (SRL) and mycophenolate mofetil (MMF) has been evaluated as part of a prospective study comparing SRL and cyclosporin A (CsA) as a primary immunosuppressant. Normal risk de novo kidney recipients were randomized either to SRL or to CsA. Additional immunosuppressants consisted of MMF and prednisone. In patients with erythrocyte microcytosis, iron deficiency was excluded by measuring serum ferritin and transferrin saturation rate. Fifty-nine patients (30 in SRL and 29 in CsA) were included. Mean corpuscular volume (MCV) (fl) on day 7 was 91.7 +/- 4.8 in SRL group versus 91.4 +/- 4.2 in CsA group (P = 0.77), whereas mean MCV on day 183 post-transplant was 78.5 +/- 3.8 in SRL group versus 88.4 +/- 3.4 in CsA group (P < 0.0001). Hemoglobin concentration (g/dl) was not significantly different. Only two patients in SRL group presented decreased transferrin saturation rate. Marked erythrocyte microcytosis without persistent anemia was observed in patients treated with SRL and MMF.