蔗糖铁注射液治疗腹膜透析患者肾性贫血的临床研究

Intravenous iron sucrose therapy in anemic peritoneal dialysis patients

目的：比较静脉用蔗糖铁与口服琥珀酸亚铁治疗腹膜透析患者肾性贫血的疗效与安全性。方法：57例患者分为静脉组22例，口服组35例；两组均应用重组人红细胞生成素120～150u／kg，1次／周，皮下注射；静脉组加用蔗糖铁100mg稀释于100mL生理盐水中静脉滴注，2～3次／周；口服组加用琥珀亚酸铁口服，200mg／次，3次／d。结果：治疗后血红蛋白、红细胞压积、网织红细胞均较治疗前显著升高；静脉组血红蛋白、红细胞压积升高比口服组显著（P〈0．01），血红蛋白上升速度明显快于口服组；静脉组血清铁、铁蛋白、转铁蛋白饱和度均明显升高（P〈0．01）；口服组铁蛋白治疗后较治疗前显著升高（P〈0．05），但血清铁、转铁蛋白饱和度治疗前后比较差异无统计学意义；静脉组血清铁、铁蛋白、转铁蛋白饱和度治疗前后与口服组比较差异有统计学意义（P〈0．01）。肝功能、肾功能等指标治疗前后差异无统计学意义，静脉组未发现1例不良反应，口服组4例出现不良反应。结论：静脉用铁剂蔗糖铁治疗腹膜透析患者肾性贫血安全、有效。

Objective To determine and compare the efficacy and safety of intravenous iron sucrose with oral ferrous succinate for renal anemia in the patients with peritoneal dialysis. Methods Fifty- seven patients were divided into IV group （n= 22） and oral group（n = 35）. After the using of rHuEPO 120 to 150 u/kg per week, IV group received 100 mg iron sucrose plus 100 mL saline intravenously during each peritionta dialysis session with while the oral group took ferrous succinate 600 mg per day orally for eight weeks. The efficacy and safety was compared. Results The Hb, hematocrit and reticulocyte were significantly increased in both groups, while Hb and hematocrit in IV group were significantly higher than those in oral group（P〈0.01）, and Hb in IV group increased much quicker than oral group, which decreased the dosage of rHuEPO. Serum iron, ferritin and transferring saturation increased significantly in IV group （P〈0.01）, as well as ferritin increased significantly in oral group （P〈0. 05）. But there was no remarkable change in serum iron and transferring saturation in oral group. There was a statistic difference between the increase of serum iron, ferritin and transferring saturation in IV group than that in oral group （P〈0.01）. There was no statistic difference in the hepatic and renal function after the trial. Four patients had adverse reactions （10.8%） in oral group and none in IV group （P〈0.05）. Conclusion The intravenous iron sucrose is effective and safe in treating anemic peritoneal dialysis patients.