静脉和口服铁剂治疗透析患者肾性贫血的疗效观察

Therapeutic effect of intravenous and oral chalybeatus on maintenance dialysis patients with renal anemia

目的观察静脉制剂蔗糖铁和口服制剂琥珀酸亚铁分别联合促红细胞生成素(EPO)治疗维持性血液透析患者肾性贫血的疗效与安全性。方法将52例血液透析患者随机分为静脉组和口服组,每组各26例。静脉组患者于血液透析时使用蔗糖铁100 mg,直至完成总预计补铁量。口服组患者服用琥珀酸亚铁200 mg,每日3次,共12周。全部病例都合并应用促红细胞生成素治疗,剂量为120～150 U.kg-1.w-1,皮下或静脉应用。观察并比较两组患者治疗贫血的效果、铁代谢指标的变化及不良反应发生的情况。结果治疗后两组患者血红蛋白、血细胞比容和血清铁蛋白均较治疗前升高,但口服组升高不明显,升高幅度两组相比差异有统计学意义(P<0.05)。不良反应:静脉组有1例出现皮肤瘙痒,口服组偶有恶心、腹胀。结论蔗糖铁是治疗肾性贫血的一种安全、有效的药物,静脉补铁比口服补铁效果更好。

Objective To compare the efficacy and safety of intravenous iron sucrose and oral ferrous succinate in anemia hemodialysis patients underwent the treatment with rHu-EPO. Methods Fifty-two patients accepted maintenance hemodialysis were randomly divided into 2 groups： intravenous iron group and oral iron group. The intravenous group was performed with 100mg iron sucrose intravenous drip in each dialysis session until total supplement iron amount, and the oral one was performed with 200mg ferrous succinate, three times one day for 12 weeks. Each patient treated with rHu-EPO by 120-150U·kg^-1·w^-1. The efficacy was assessed by calculating the subsequent ehange in hemoglobin （Hb）, hematoerit （Hot）, serum ferritin （SF）. The adverse events were also observed. Results After the treatment, the levels of Hb, Her and SF in both groups increased, but increasing rate was lower in oral ferrous suecinate group. The rising degree had significant differ- ence between the two groups. There was 1 ease suffered from skin itching in intravenous iron group, and 2 eases felt sick or abdominal disten- sion. Conclusion The intravenous iron sucrose is effective and safe in treating renal anemia and this treatment may induce superior efficacy to oral ferrous succinate.