Περίληψη:
AIM: Anaemia caused by acute upper gastrointestinal bleeding is treated
with blood transfusion or iron, but patients usually face a two-month
recovery period from post-haemorrhage anaemia. This prospective,
randomised, open, pilot study was designed to investigate whether
recombinant human erythropoietin (Epoetin) therapy accelerate
haematocrit increase in the post-bleeding recovery period.
METHODS: We studied hospitalised patients admitted because of acute
ulcer bleeding or haemorrhagic gastritis, who had a haematocrit of
27-33% and did not receive blood transfusions. One day after the
endoscopic confirmation of cessation of bleeding, they were randomised
either to erythropoietin (20 000 IU Epoetin alfa subcutaneously, on days
0, 4 and 6) plus iron (100 mg im, on days 1-6, (G(1)) or iron only
(G(2)). Haematocrit was measured on days 0, 6, 14, 30, 45, and 60,
respectively.
RESULTS: One patient from G1 and two from G2 were lost to follow-up.
Therefore, 14 and 13 patients from G1 and G2 respectively were analysed.
Demographic characteristics, serum iron, ferritin, total iron binding
capacity, reticulocytes, and haematocrit were not significantly
different at entry to the study. Median reticulocyte counts were
significantly different between groups on day six (G(1): 4.0, 3.0-6.4 vs
G(2): 3.5, 2.1-4.4%, P=0.03) and median haematocrit on day fourteen
[G(1): 35.9, 30.7-41.0 vs G(2): 32.5, 29.5-37.0% (median, range),
P=0.04].
CONCLUSION: Erythropoietin administration significantly accelerates
correction of anemia after acute ulcer bleeding. The haematocrit gain is
equivalent to one unit of transfused blood two weeks after the bleeding
episode.
Συγγραφείς:
Ladas, Spiros D.
Polymeros, Dimitrios
Pagonis, Thomas and
Triantafyllou, Konstantinos
Paspatis, Gregorios
Hatziargiriou,
Maria
Raptis, Sotirios A.
