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红细胞生成的调节因子—促红细胞生成素(EPo)主要产生于肾脏,分子量为39000的糖蛋白。其全部氨基酸排列已经清楚。最近,放射免疫测定法正在普及,以红细胞增多症、肾性贫血的病理生理机制的闸明为契机,其临床意义更加提高。老年人骨髓脂肪量增加,造血范围变窄,有核细胞减少。在EPo 存在和离体情况下,红细胞集落形成的EPo 反应细胞(ERC),在70岁以上的老年人也呈有意义减少。老年人,尤其是癌症及脑血管障碍患者,BFU-E 减少。EPo 的生成受男性激素、氧消耗的影响,但老年人随着年龄增长,男性激素分泌降低,氧消耗减少,EPo 生成减少的主要原因及EPo 不足,ERC 的分化和增殖受抑,可认为是老年性贫血的原因之一。一、肾性贫血老年人以慢性肾小球肾炎,开始,大多可见由前列腺肥大、肾盂肾炎、糖尿病性肾病等引起的肾功不全。而肾脏损害的病例,大部分可见贫血症,主要原因为EPo 生成低下。同时还可能有PTH 或胺等血清中造血抑制因子存在。此外,还可能有来自肾功不全的代谢产物蓄积所致溶血或出血倾向。部分长期透析
Regulator of Erythropoiesis - Erythropoietin (EPo) is produced mainly in the kidney and has a molecular weight of 39,000 glycoproteins. The complete amino acid alignment is clear. Recently, radioimmunoassay is gaining popularity. With the introduction of the pathophysiological mechanism of polycythemia and renal anemia, the clinical significance has been further improved. Increased bone marrow fat in the elderly, hematopoietic range narrowed, reduced nucleated cells. In the presence of EPo and ex vivo, erythrocyte-forming EPo reactive cells (ERC) also have a significant reduction in the elderly over the age of 70 years. BFU-E is reduced in the elderly, especially in patients with cancer and cerebrovascular disorders. EPo production by male hormones, oxygen consumption, but the elderly with age, lower male hormone secretion, reduced oxygen consumption, EPo generation reduced the main reasons and lack of EPo, ERC differentiation and proliferation suppressed, can be considered as One of the causes of senile anemia. First, renal anemia Chronic glomerulonephritis in the elderly, the beginning, most of the visible by the enlarged prostate, pyelonephritis, diabetic nephropathy and other renal insufficiency. The majority of cases of kidney damage are anemia, mainly due to low EPo production. At the same time there may be PTH or amine and other serum hematopoietic inhibitory factor exists. In addition, there may be hemolysis or bleeding tendency due to accumulation of metabolic products of renal insufficiency. Part of the long-term dialysis