静脉补铁对维持性血液透析患者的贫血及微炎症状态的影响

Influence of intravenous iron supplementation on anemia and microinflammation in hemodialysis patients

目的:探讨静脉补铁对维持性血液透析患者的贫血及微炎症状态的影响。方法:选择血液透析患者90例,随机分为静脉组(30例)、口服组(30例)和未补铁组(30例)。观察用药前后血红蛋白浓度、红细胞压积、血清铁、血清铁蛋白、转铁蛋白饱和度等疗效指标以及血清C反应蛋白、白介素-6、白介素-10、肿瘤坏死因子-α等炎症指标并监测不良反应。结果:8周后,静脉组血红蛋白水平及血清铁蛋白较治疗前明显改善(P<0.01);血浆及血清C反应蛋白,白介素-6,肿瘤坏死因子-α均较治疗前显著升高(P<0.01或P<0.05)。结论:静脉补铁有效改善患者的贫血及缺铁,也加剧了其炎症状态。

Objective To investigate the influence of intravenous iron therapy on anemia and microinflammation in the patients undergoing maintenance hemodialysis. Methods Ninety maintenance hemodialysis patients were randomly divided into intravenous iron group （n=30）, oral iron group （n=30） and non-iron group （n=30）. Their hematocrit, hemoglobin, serum iron, serum ferrintin, transferrin saturation and biomarkers of inflammation as serum C-reactive protein, interleukin-6, interleukin-10 and tumor necrosis factor-α, were measured at the beginning and the end of the study. Results After eight weeks, hemoglobin and serum ferrintin levels were significantly higher in intravenous group than those before treatment （P〈0.01）. C-reactive protein, interleukin-6 and tumor necrosis factor-α were increased significantly in intravenous group （P〈0.01 or P〈0. 05）. Conclusion Erythropoietin and iron administration is important for treating anemia. Iron supplementation also aggravates the status of microinflammation.