静脉补充铁剂治疗维持性血液透析患者肾性贫血的疗效观察

Clinical observation on the efficiency of intravenous sucrofer combined with erythropoiesis stimulating factor in treatment of patient with refractory renal anemia

目的观察蔗糖铁注射液联合促红细胞生成素治疗肾I生贫血的疗效及安全性。方法30例口服铁剂联合促红素治疗不理想的尿毒症维持性血液透析患者16例（蔗糖铁组）改用静脉滴注蔗糖铁100mg，2次／周，总量达1000mg，后改为100mg，1～2次／周；14例（硫酸亚铁组）继续口服硫酸亚铁0．2g，3次／d，促红细胞生成素的使用剂量和方法两组相同，总疗程均为8周。结果蔗糖铁组血红蛋白为（81．42±9．45）g／L，较硫酸亚铁组（89．32±9．18）g／L显著升高（P〈0．01），红细胞比容显著升高（P〈0．01），血清铁蛋白显著增加（P〈0．01）；患者精神、食欲、体力、生活质量等均明显改善；蔗糖铁组有效率81．3％，偶有恶心、呕吐、皮肤刺痒，均无明显副作用；硫酸亚铁组血红蛋白水平上升幅度有限，多数有恶心、上腹不适，影响食欲。结论蔗糖铁联合促红细胞生成素治疗肾陛贫血疗效优于口服铁剂联合促红细胞生成素治疗，且不良反应较少。

Objective To investigate the clinical efficiency and security of Fe （OH） 3-sucrose-compond combined with erythropoietin on renal anemia. Methods 30 cases of oral iron combined with erythropoietin in the unsatisfactory uremia patients undergoing maintenance hemodialysis, the cases were randomly divided into two groups： the treatment group（ n = 16） using intravenous sucrose iron 100mg,twice a week, after a total of 1000mg, then 100mg, once 1 - 2 weeks ; the control group （ n = 14 ） continue to oral ： ferrous succinate 0.2g, three times everyday, erythropoietin dose was the same in lothgroups for 8 weeks. Results Hemoglobin was significantly higher （ P 〈 0.01 ） and hematocrit was significantly higher （P 〈0.01 ）,and serum ferritin significant increased （P 〈0.01 ） in sucrose iron treatment group than these of the control group ; the patients of treatment group have obviously improved in spirit, appe- tite, physical and life quality and so on. Sometimes, nausea, vomiting, skin itching were complained lut without signifi- cant side effects. While in the control group limited increase in the level of hemoglobin was seen,the majority had nausea,abdominal discomfort, poor appetite. Conclusion The efficiency of intravenous sucrofer combined with erythropoietin in treatment of renal anemia was effective than conventional oral iron combined with erythropoietin and with fewe adverse reactions.