静脉补铁与口服补铁治疗肾性贫血的疗效观察

Effect of Intravenous Iron Supplement on Renal Anemic Patients

目的:比较静脉铁与口服铁对维持性血透患者应用基因重组人促红细胞生成素(rHuEPO)治疗肾性贫血的作用。方法:将60例规律透析3个月以上尿毒症患者随机分为静脉补铁组和口服补铁组,每组30人。静脉补铁组每周静脉补充蔗糖铁1次,每次100mg;口服补铁组口服琥珀酸亚铁200mg,3/日,共8周,并同时应用rHuEPO 6000U^10000U,1次/周。治疗前、后检查每位患者的血红蛋白(Hb)、红细胞比容(Hct)、血清铁(SI)、血清铁蛋白(SF)、总铁结合力(TIBC),计算出转铁蛋白饱和度(TSAT,TSAT=SI/TIBC×100%),并记录药物的副反应。结果:两组治疗8周后Hb、Hct水平均明显升高,但静脉补铁组与口服补铁组比较差异显著(P<0.05);治疗后静脉补铁组SF、TSAT较治疗前及口服补铁组明显升高(P<0.05),而口服补铁组治疗前、后SF、TSAT无明显变化。结论:在使用rHuEPO的同时,静脉补铁更能有效纠正血透患者的肾性贫血。

Objective： To compare the effects of intravenous iron and oral iron in renal anemic hemodialysis patient with rHuEPO treatment. Methods： Sixty patients of uremia for regularity hemodiasis more then three months randomly were divided into intravenous iron group （n= 30） and oral iron group （n= 30） . All patients were treated with 6000- 10000U rHuEPO , pre week. Patients in intravenous iron group received 100 mg iron sucrose pre week . Patients in oral iron group took ferrous sueeinite 200rag tid . Both groups were treated as long as 8 weeks . Their hemoglobin （Hb） , hematoerit （Het） , serum iron （SI） , serum ferritin （SF） , total iron-binding capacity （TIBC）, transferritin saturation （TSAT） were monitored at the beginning and the end of the study . Results： At the end of the trial , the Hb and Hct in both groups significantly increased respectively , but the Hb and Hct in intravenous iron group were significantly higher than that in oral iron group （P〈0.05）. In intravenous iron group , the SF and the TAST after the therapy were significantly higher than that before the therapy and also significantly higher than that in oral iron group （P〈0.05）. In oral iron group , the SF and the TAST after the therapy did not change significantly Conclusions： In renal anemic hemodialysis patient with rHuEPO, intravenous iron supplement might show better effects than oral iron supplement .