摘要
目的比较不同方式补铁治疗对血液透析患者在肾性贫血得以纠正达标后长期维持治疗期间的疗效和安全性,从而选择更佳的维持性治疗方式。方法选择2014年9月至2016年3月在湖北省中医院血液净化中心行维持性血液透析的患者40例,经规范治疗肾性贫血相关指标达标后,随机分为静脉组和口服组,每组20例。静脉组患者每周第一次透析时给予静脉注射蔗糖铁100mg,口服组患者口服多糖铁复合物胶囊150 mg,每日一次。2组患者均合并使用促红细胞生成素(erythropoietin,EPO)治疗,剂量为10 000 U/10d。观察12周后2组患者红细胞数量(red blood cell,RBC)、血红蛋白(hemoglobin,Hb)、红细胞比容(hematocrit,Hct)、血清铁蛋白(serum ferritin,SF)、转铁蛋白饱和度(transferin saturation,TSAT)、C反应蛋白(C reaction protein,CRP)等指标的变化及不良反应。结果治疗前静脉组和口服组患者在Hb、RBC、SF、TSAT和Hct等方面无明显差异(P>0.05)。2组患者分别经过12周治疗后,Hb、RBC、SF等水平有下降趋势,口服组患者下降幅度更为明显。静脉组患者无明显不良反应。结论血液透析患者在肾性贫血得以纠正达标后仍维持性补充铁剂是有必要的。维持性静脉注射蔗糖铁与口服多糖铁复合物胶囊联合EPO治疗都能用于稳定大多数患者相关铁参数和Hb水平,但静脉注射蔗糖铁更为安全、有效,且依从性更高。
Objective To compare the efficacy and safety of different modes of maintenance iron supplementation in dialysis patients whose renal anemia were combated,in order to find a better strategy of maintenance iron supplementation. Methods Forty hemodialysis patients whose renal anemia were combated in our Hemodialysis Center from September 2014 to March 2016 were divided into two groups randomly and treated with intravenous iron sucrose and oral polysaccharide iron complex respectively. Intravenous iron sucrose group（ intravenous group） was given intravenous iron sucrose（ 100 mg,once a weak）,and oral medication group（ oral group） received poly saccharide iron complex（ 150 mg,once daily for 12 weeks）.The count of red blood cells（ RBC）,Hb,Hct,SF,TSAT and CRP were examined before and 12 weeks after treatment. Results The Hb,RBC,SF,TSAT and Hct between the two groups had no significant difference before and after treatment（ P〉 0. 05）. As compared with those before treatment,the levels of Hb,RBC,SF of all patients at 12 th week were reduced,especially in the oral group. No adverse event was found in intravenous group. Conclusions Maintenance iron supplementation is essential for dialysis patients even though their renal anemia was mended. Both of intravenous iron sucrose and oral polysaccharide iron complex associated with EPO could be chosen to stabilize the parameters about iron and the level of Hb,but the mode of intravenous iron sucrose is safer and more efficacious,and easier to carry out.
出处
《临床肾脏病杂志》
2017年第8期482-485,共4页
Journal Of Clinical Nephrology
基金
武汉市科技局科技攻关项目(No.201552199592)
关键词
补铁
血液透析
肾性贫血
Iron supplementation
Hemodialysis
Renal anemia
