不同静脉补铁方法治疗血液透析患者肾性贫血的对照研究

Study on the Renal Anemia for the Patients with Hemodialysis by Different Intravenous Iron Method

目的:比较不同静脉补铁方法治疗血液透析患者肾性贫血的临床效果。方法:选取本院收治的90例慢性肾功能衰竭维持性血透的肾性贫血患者,按照随机数字表法均分为A、B、C三组,A组患者给予周期性补铁治疗,B组患者给予维持性补铁治疗,C组患者给予周期性补铁+维持性补铁治疗,比较三组患者治疗前后血清Hb、ACT、SF、TSAT、CRP水平变化情况以及不良反应发生情况。结果:三组治疗12、24周后Hb、HCT、SF、TSAT水平均显著升高,与治疗前比较,差异均有统计学意义(P<0.05);A组治疗12、24周后Hb、HCT、SF、TSAT水平均显著高于B组,差异具有统计学意义(P<0.05);C组治疗12、24周后Hb、HCT、SF、TSAT水平均显著高于A组和B组,差异具有统计学意义(P<0.05);三组治疗12周与24周的Hb、HCT、SF、TSAT水平比较差异均无统计学意义(P>0.05);三组治疗前后血清CRP水平均无明显变化,差异无统计学意义(P>0.05)。三组治疗期间未发生明显不良反应。结论:周期性补铁+维持性补铁为治疗血液透析患者肾性贫血的最佳补铁方案,能够快速有效为患者提供储存铁和功能铁。

Objective：To explore the clinical effects of the renal anemia for the patients with hemodialysis by different intravenous iron method. Method：90 patients with chronic renal failure maintenance hemodialysis and renal anemia were selected,they were randomly divided into the group A,B,C. The group A was treated by periodic iron,the group B was treated by maintenance of iron,the group C was treated by periodic iron＋maintenance of iron. The levels of Hb,HCT,SF,TSAT,CRP and the complication were compared. Result：After treatment for 12,24 weeks,the levels of Hb,HCT,SF,TSAT were higher than prior treatment（P〈0.05）;after treatment for 12,24 weeks,the levels of Hb, HCT,SF,TSAT for the group A were higher than group B（P〈0.05）;the levels of Hb,HCT,SF,TSAT for the group C were higher than group A and group B（P〈0.05）;treatment for 12 weeks compared with 24 weeks,the differences of the level of Hb,HCT,SF,TSAT in the three groups had no statistical significance（P〉0.05）. There was no significant difference on the levels of CRP for the three groups（P〉0.05）. There was no obvious adverse reactions for the three groups. Conclusion：periodic iron＋maintenance of iron for the patients with renal anemia is the best way to source of iron,it can provide storage iron and function of iron fast and efficient.